Primary CNS demyelinating diseases in childhood: multiple sclerosis

Iannetti, Paola; Marciani, M.G.; Spalice, Alberto; Spanedda, F.; Raucci, Umberto; Trasimeni, G.; Gf, Gualdi; Bernardi, Giorgio

doi:10.1007/bf00266819

Cited by 11 publications

(4 citation statements)

References 24 publications

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“…Given this, an initial priority was to define the clinical features of pediatric-onset MS. Since 1980, several key articles have characterized MS onset in childhood, [10][11][12][13][14][15][16][17][18][19][20][21] and led to a multinational collaboration. 22 The tendency for very young patients with MS to manifest with polyfocal neurologic deficits and a high frequency of brainstem symptoms at onset were noted.…”

Section: Pediatric Multiple Sclerosismentioning

confidence: 99%

Pediatric multiple sclerosis

Banwell

2016

Neurology

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In 1952, Sydney Carter, MD (1912MD ( -2005; Professor Emeritus, Columbia University), was asked to establish the first independent child neurology program at Columbia Presbyterian Hospital. Prior to this, children with neurologic disorders were largely cared for by general pediatricians, or on occasion, and often with trepidation, by adult neurologists. Dr. Carter recognized the unique care needs of the pediatric neurology patient. He prioritized the requirement to harmonize neuroscience and neurodevelopment, and advocated the need to identify the hallmarks of neurologic illness in the context of the developing central and peripheral nervous systems, and to foster training programs specifically in Child Neurology.It is my sincere honor to be the 2015 Sydney Carter Award recipient, and to pay service to the many colleagues whose dedication, brilliance, and compassion have contributed immeasurably to the content of this lecture. In my lecture, and herein, I summarize the learning curve and milestones achieved in pediatric multiple sclerosis (MS) care and research to date. I have endeavored to mention the work of international colleagues and to emphasize the Canadian Pediatric Demyelinating Disease program. The Canadian program began with a 3-year survey of over 2,400 pediatric health care providers 1-3 to estimate the annual incidence of acute demyelination in Canadian children. 4 Through the creation of the Canadian Pediatric Demyelinating Disease Network with funding by the Multiple Sclerosis Scientific Research Foundation, a prospective cohort (2004-present), a centralized database, biorepository, and high-quality research MRI dataset have contributed to our understanding of the clinical, genetic, epidemiologic, and imaging characteristics of MS in children.Just as Dr. Carter identified a fundamental need for pediatric neurology, formal programs for pediatriconset MS were also born from recognition of a clinical care need. Before 1980, search of the English literature yielded fewer than 30 publications on the topic of pediatric MS, and many believed that MS was a disease solely of adults (reviewed in Ref. 5). The available MS diagnostic criteria proposed by Poser et al.6 specifically excluded the diagnosis of MS in persons younger than 10 years, and did not formally comment on MS in youth. Further complicating the diagnosis and care of pediatric patients with MS is the fact that approximately 70% of pediatric patients with acute demyelination will have a transient illness without clinical or MRI evidence of new lesions over time. Acute disseminated encephalomyelitis (ADEM) typifies monophasic demyelination, particularly in young children. Distinguishing such patients from the 30% ultimately confirmed to have MS has been the focus of much of the research performed in the last 15 years. 7-9The diagnosis of MS rests on clinical features. There are no diagnostically specific genetic mutations or biomarkers for MS. Given this, an initial priority was to define the clinical features of pediatric-onset MS. Since 1980...

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Section: Pediatric Multiple Sclerosismentioning

confidence: 99%

Pediatric multiple sclerosis

Banwell

2016

Neurology

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“…Open-label studies have supported the safety and efficacy of these drugs. 90 The results of a retrospective longitudinal open label study of 258 MS patients with pediatric onset, indicated that IFNb and GA were the most common prescribed drugs. IFNb was prescribed to 200 (77.5%) and GA was prescribed to 53 (20.5%) patients as the first line treatment.…”

Section: Pediatric Multiple Sclerosis (Ms) Immunopathogenesis and Thmentioning

confidence: 99%

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data

Vitaliti

Tabatabaie

Matin

et al. 2015

Human Vaccines & Immunotherapeutics

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“…The diagnosis of MS in pediatric age is not easy to achieve because of difficulties for clinicians in recognizing the patients that do not fit the typical age range of 20-40 years [15]. In addition, the trouble of the differential diagnosis is linked to other inconveniences such as the many types of primary or secondary CNS disorders resembling demyelinating diseases, or the atypical presentation of clinical (fever, involvement of peripheral nervous system, encephalopathy, absence of attacks symptoms, progressive course), laboratory [absence of cerebrospinal fluid (CSF) oligoclonal IgG, CSF pleocytosis, elevation of leukocyte count or erythrocyte sedimentation rate], neuroimaging findings [16, 17].…”

Section: Multiple Sclerosismentioning

confidence: 99%

Clinical and Pharmacological Aspects of Inflammatory Demyelinating Diseases in Childhood: An Update

Spalice

Parisi²,

Papetti³

et al. 2010

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Inflammatory demyelinating diseases comprise a spectrum of disorders affecting the myelin of the central and peripheral nervous system. These diseases can usually be differentiated on the basis of clinical, radiological, laboratory and pathological findings. Recent studies have contributed to current awareness that inflammatory demyelinating diseases are not restricted to the adult age group, but are more common in pediatric age than previously believed. Some of pediatric inflammatory demyelinating diseases carry an unfavorable long-term prognosis but appropriate treatments can improve the outcome. The possibility of physical and cognitive disability resulting from these diseases, highlights the urgent need for therapeutic strategies for neurorehabilitation, neuroregeneration, and neurorepair. This review discusses characteristics of primary demyelinating diseases more frequently observed in childhood, focusing on epidemiology, clinical aspects and treatments.

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Primary CNS demyelinating diseases in childhood: multiple sclerosis

Cited by 11 publications

References 24 publications

Pediatric multiple sclerosis

Pediatric multiple sclerosis

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data

Clinical and Pharmacological Aspects of Inflammatory Demyelinating Diseases in Childhood: An Update

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