Pediatric Multiple Sclerosis—A Challenging Demyelinating Disease: Case Report and Brief Review of the Literature

Albuquerque, Regina; Paula, Raquel Siqueira Leonel de; Brito, Manuelina Mariana Capellari Macruz; Filho, José Pissolato; Meguins, Lucas Crociati

doi:10.1155/2012/684064

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…MS is more commonly seen in females than males, with a female-to-male ratio of 2:1 [ 8 ]. MS is very rarely reported in early childhood [ 9 ]. In this report, we present the case of a six-year-old South Asian boy who experienced multiple relapses of MS with varied neurological presentations.…”

Section: Introductionmentioning

confidence: 99%

Early-Onset Multiple Sclerosis With Frequent Relapses: A Challenging Diagnosis With a Less Favorable Prognosis

Thadchanamoorthy¹,

Dayasiri²

2021

Cureus

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Pediatric multiple sclerosis (MS) is a rare demyelinating disease of the brain, spinal cord, and optic nerve caused by immune modulators mediating against the neuronal axons of the central nervous system. MS is usually characterized by a series of neurological events, without any features of encephalopathy, separated in time and space. The complications arise from the permanent degeneration of the nerves. This condition can be diagnosed based on International Pediatric Multiple Sclerosis Study Group diagnostic criteria, and there is no definitive treatment for MS. We report the case of a male child who was diagnosed with MS at the age of six years when he presented with right hemiparesis and visual impairment. Subsequently, he had multiple relapses with varied neurological presentations, and each relapse was treated with methylprednisolone.

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Section: Introductionmentioning

confidence: 99%

Early-Onset Multiple Sclerosis With Frequent Relapses: A Challenging Diagnosis With a Less Favorable Prognosis

Thadchanamoorthy¹,

Dayasiri²

2021

Cureus

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“…Diagnosing a specific POMS often requires much more extensive observation periods as well as extra-prudent differential diagnosis [26]. In our own study, the time between the onset of symptoms and diagnosis was longer in the case of younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005).…”

Section: Discussionmentioning

confidence: 57%

The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

Brola

Steinborn

Žák

et al. 2022

JCM

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Background. Paediatric-onset MS (POMS) has a unique clinical profile compared to the more prevalent adult-onset MS. For this study, we aimed to determine the demographic and clinical characteristics of POMS in Poland as well as addressing some of its epidemiological aspects. Methods. A retrospective study was conducted based on the Polish Multiple Sclerosis Registry, considering a population of children and adolescents with MS (age ≤ 18 years). Data were collected by all 13 centres across Poland specializing in diagnosing and treating POMS. The actual course of the disease and its clinical properties were compared between child (≤12 years) and juvenile (>12 years) patients. MS onset and its prevalence were assessed at the end of 2019, stratified by age range. Results. A total of 329 paediatric or juvenile patients (228 girls, 101 boys) with a clinically definite diagnosis of MS, in conformity with the 2017 McDonald Criteria, were enrolled. For 71 children (21.6%), the first symptoms appeared before the age of 12. The female: male ratio increased with age, amounting to 1:1 in the ≤12 years group and to 2.9:1 in the >12 years group. In most cases, the disease had multi-symptomatic onset (31.3%), and its course was mostly of a relapsing–remitting character (95.7%). The initial Expanded Disability Status Score for both groups was 1.63 ± 1.1, whereas the annual relapse rate was 0.84 during the first 2 years. The time between the onset of symptoms and diagnosis was longer in the younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005). On 31 December 2019, the age-adjusted prevalence standardized to the European standard population was 5.19/100,000 (95% CI, 4.64–5.78). Significantly higher prevalence was noted in the 13–18 years group (7.12; 95% CI, 6.64–7.86) than in the 9–12 years group (3.41; 95% CI, 2.98–3.86) and the <9 years group (0.56; 95% CI, 0.46–0.64; p < 0.001). Conclusion. POMS commencing at the age of ≤12 years is rare, differing significantly from the juvenile-onset and adult MS in terms of clinical characteristics, course, and incidence, as stratified by gender.

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“… 25 , 26 Searching the literature for pediatric MS with sixth nerve palsy, one case was reported from Brazil, a child with MS who presented with diplopia and convergent strabismus and found to have sixth nerve palsy. 27 …”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis Presenting with Sixth Nerve Palsy in a Child

Al-Yousuf¹,

Aljutaili²,

AlHuwais³

et al. 2021

IMCRJ

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We report a child with multiple sclerosis who presented with sixth nerve palsy. She is a twelve-year-old Bahraini female presented to the ophthalmology department complaining of double vision. She also had imbalance and paraesthesia. Extraocular muscle examination showed restriction of abduction in the right eye. There was no change in vision. MRI showed right eye optic neuritis (ON) and demyelination which was indicative of multiple sclerosis (MS). Ocular coherence tomography (OCT) showed thinning of nerve fibres of both eyes which was consistent with subclinical optic neuritis. Neurological examination showed brisk knee jerk on the left side and incoordination of movement on the same side. Disability Status Scale (EDSS) showed a score of 3.0. She was given Solu-medrol 500 mg intravenously (IV) in addition to omeprazole 40 mg IV and Vitamin D3 (cholecalciferol) 50,000 IU cap weekly for 8 weeks and Neurorubine forte tablets (vitamin B1, 6, 12) once a day for 2 months. She became asymptomatic in her follow-up visits. Children with MS can present as sixth cranial nerve palsy. Clinicians should have a high index of suspicion for early diagnosis and treatment. In addition to MRI, OCT is a useful diagnostic tool for optic neuritis and MS especially in children.

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Pediatric Multiple Sclerosis—A Challenging Demyelinating Disease: Case Report and Brief Review of the Literature

Cited by 7 publications

References 20 publications

Early-Onset Multiple Sclerosis With Frequent Relapses: A Challenging Diagnosis With a Less Favorable Prognosis

Early-Onset Multiple Sclerosis With Frequent Relapses: A Challenging Diagnosis With a Less Favorable Prognosis

The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

Multiple Sclerosis Presenting with Sixth Nerve Palsy in a Child

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