Differential Diagnosis of Pediatric Multiple Sclerosis

Galardi, Maria M.; Gaudioso, Cristina; Ahmadi, Saumel; Evans, Emily; Gilbert, Laura; Mar, Soe

doi:10.3390/children6060075

Cited by 9 publications

(13 citation statements)

References 125 publications

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“…Additionally, it has been seen that contrast enhancement in spinal cord lesions in NMO display a rim-enhancement as compared to MS where more uniform enhancement is seen [51]. Due to selective involvement in the area postrema, 38% of pediatric NMO patients present with vomiting [52]. CSF can display significant pleocytosis with neutrophilic or lymphocytic predominance, and oligoclonal bands are less frequently seen than in MS [53,54].…”

mentioning

confidence: 99%

Current Advances in Pediatric Onset Multiple Sclerosis

et al. 2020

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Multiple sclerosis (MS) is an autoimmune inflammatory disease affecting the central nervous system leading to demyelination. MS in the pediatric population is rare, but has been shown to lead to significant disability over the duration of the disease. As we have learned more about pediatric MS, there has been a development of improved diagnostic criteria leading to earlier diagnosis, earlier initiation of disease-modifying therapies (DMT), and an increasing number of DMT used in the treatment of pediatric MS. Over time, treatment with DMT has trended towards the initiation of higher efficacy treatment at time of diagnosis to help prevent further disease progression and accrual of disability over time, and there is evidence in current literature that supports this change in treatment patterns. In this review, we discuss the current knowledge in diagnosis, treatment, and clinical outcomes in pediatric MS.

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mentioning

confidence: 99%

Current Advances in Pediatric Onset Multiple Sclerosis

et al. 2020

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“…In children whose first onset occurs before 11 years of age, there exists equal prevalence of the disease . Contrasting with this, pediatric cases that occur after 11 years of age, which coincides with the pubertal period and increase in circulating sex hormones, display a sex difference similar to that in adults; with females twice as likely to have the disorder when compared to males . Although, overall, women are more likely to have the disorder with earlier onset, men exhibit more severe and rapid progression of the disease .…”

Section: Myelin Maturationmentioning

confidence: 95%

“…97 Contrasting with this, pediatric cases that occur after 11 years of age, which coincides with the pubertal period and increase in circulating sex hormones, display a sex difference similar to that in adults; with females twice as likely to have the disorder when compared to males. 97,98 Although, overall, women are more likely to have the disorder with earlier onset, men exhibit more severe and rapid progression of the disease. 7,19 In a human study assessing sex differences in human brain volume at the onset of the disease, it was found that in women whose disease onset occurred before menopause, there exists a structural difference in brain volume compared to males.…”

Section: Synaptic Maturationmentioning

confidence: 99%

Adolescent maturation of the prefrontal cortex: Role of stress and sex in shaping adult risk for compromise

Shaw

Dupree

Neigh

2019

Genes Brain and Behavior

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Adolescence is a highly dynamic period of development, which includes the final organizational phases of neural maturation within the prefrontal cortex (PFC). The organizational events of neural pruning and myelination occur in a sex‐specific manner, potentially giving rise to the disparities in mood disorders in adulthood. Because of the extended developmental time period of the PFC, environmental insults, including psychosocial stressors, may play a major role in steering the maturation of this region. In this review, the literature surrounding the sex specific alterations that occur in the PFC in rodent models following adolescent stress will be discussed. This will be complimented by a brief review on the state of human research in PFC sex differences in the development of white matter and cytoarchitecture across the lifespan. Taken together, the impact of developmental psychosocial stress on the circuitry of the PFC and resulting adult phenotypes will be summarized with a focus on the importance of considering sex differences in order to build a better understanding of developmental influences on adult disorders.

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“…Because primary progressive MS (PPMS) is rare in children, leukodystrophy, inborn error of metabolism, mitochondrial diseases, and neuromyelitis optica can be misdiagnosed. MS should be ruled out in every child with continuous disability without specific attacks [7].…”

Section: Symptoms and Clinical Coursementioning

confidence: 99%

“…Over the years, the diagnostic criteria have changed several times, new drugs have been introduced, and the methods of differential diagnosis have improved [6][7][8][9]. This review presents the current state of knowledge regarding pathogenesis, epidemiology and course of the disease, and discusses the criteria for diagnosis and differential diagnosis as well as treatment of multiple sclerosis in children.…”

Section: Introductionmentioning

confidence: 99%

Pediatric multiple sclerosis – current status of epidemiology, diagnosis and treatment

Brola

Steinborn

2020

Neurol Neurochir Pol.

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Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system that mostly affects younger adults. However, the first symptoms of MS can appear in children and adolescents before the age of 18, and we call this paediatric MS (PMS).It is estimated that paediatric MS accounts for 3-5% of the general population of patients with MS. Despite the fundamental similarities to adult MS, PMS has many distinctive features. Paediatric MS has a milder course compared to adults, but leads to significant disability at an early age. PMS is relapsing-remitting in 95-98% of cases; the primary progressive manifestation is much less common than in adults. The differential diagnosis of MS in children should include other childhood demyelinating diseases, mitochondrial and metabolic diseases, connective tissue diseases, and neuroborreliosis. Differentiating acute disseminated encephalomyelitis (ADEM) from the first onset of MS remains the biggest challenge. Over the past 10 years, understanding of the epidemiology, pathophysiology, diagnosis, and treatment of MS in children has significantly expanded. The diagnostic criteria leading to earlier diagnosis and initiation of disease-modifying therapy (DMT) have changed, and the number of drugs used in children has increased. However, many important issues require further research. This review discusses the current state of knowledge regarding the epidemiology, diagnosis, and treatment of multiple sclerosis in children.

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Differential Diagnosis of Pediatric Multiple Sclerosis

Cited by 9 publications

References 125 publications

Current Advances in Pediatric Onset Multiple Sclerosis

Current Advances in Pediatric Onset Multiple Sclerosis

Adolescent maturation of the prefrontal cortex: Role of stress and sex in shaping adult risk for compromise

Pediatric multiple sclerosis – current status of epidemiology, diagnosis and treatment

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