Multiple sclerosis in childhood: clinical features of 149 cases

Abstract

From the retrospective study of 3375 patients affected by clinically definite or probable multiple sclerosis (MS), 149 patients were collected with onset of the disease before the age of 16 years (4.4%). Female/male ratio was higher than that of the adult onset MS (AOMS) population (2.2 vs 1.6) particularly at ages of onset after 12 years (3.0, P = 0.007 vs AOMS). Among initial symptoms, those suggesting brainstem dysfunction (25%) were more frequent compared to other systems and compared to AOMs symptoms; motor and sensory disturbances were slightly less frequent (respectively 17.5% and 18.3%). Optic neuritis appeared in 16.5% of cases with onset in childhood and in 16.2% of cases with AOMS, cerebellar disturbances respectively in 9.1% and 7.7%. The first interattack-interval and the clinical course of early onset MS did not differ significantly from AOMS. In early onset MS patients with disease duration < 8 years, cases with EDSS > 6 were slightly more frequent than in the AOMS group (P = 0.04). The frequency of cases for different levels of disability was similar for disease duration > 8 years.

Endogenous estrogens, through estrogen receptor α, constrain autoimmune inflammation in female mice by limiting CD4+ T‐cell homing into the CNS

“…MS is more frequently observed in women than in men [1]. This gender difference in susceptibility to MS become apparent after sexual maturity suggesting a role for endogenous sex hormones [20]. On the other hand, progression of MS to a more severe form of the disease is slower in female patients [21,22].…”

Multiple sclerosis vs acute disseminated encephalomyelitis in childhood

“…Childhood multiple sclerosis is a rare entity, composing 0.3% to 5.6% of all multiple sclerosis cases [2,8,9]. Duquette et al reported on a cohort of 125 patients with onset of multiple sclerosis before age 16 years [9].…”

Characteristics of Children and Adolescents With Multiple Sclerosis

“…[9][10][11][12] Greater awareness and interest led to increased publications, including larger case series, reports from single institutions, multicenter studies, and national and population-based surveys. [1][2][3][4][5][6][7][8][13][14][15][16][17] Pediatric-onset MS (pediatric MS) was compared with adult-onset MS in a few publications. 5,7,17,18 However, because pediatric MS is a comparatively rare disorder (frequency of 0.2 to 0.64/100 000), 7,[19][20][21][22] most investigations have been limited by relatively small sample sizes, retrospective data, or both.…”

“…Generally considered a disease of young and middle-aged adults, an estimated 2.7% to 5.4% of all patients with MS experience their first attack before 18 years of age. [1][2][3][4][5][6][7][8] Initial descriptions of childhood-onset MS appeared in case reports and small case series. [9][10][11][12] Greater awareness and interest led to increased publications, including larger case series, reports from single institutions, multicenter studies, and national and population-based surveys.…”