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[Multiple sclerosis with childhood onset].

N A Totolian, A A Skoromets, T N Trofimova

    Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
    |August 7, 2002
    PubMed
    Summary

    Early-onset multiple sclerosis (MS) presents unique symptoms and poorer outcomes compared to adult-onset MS. Identifying specific biomarkers like kappa-free light chains in cerebrospinal fluid (CSF) can aid in early diagnosis.

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    Area of Science:

    • Neurology
    • Immunology
    • Pediatrics

    Background:

    • Multiple sclerosis (MS) is a chronic neurological disease affecting adults and children.
    • Early-onset MS (before age 17) has distinct clinical and radiological features.
    • Understanding these differences is crucial for accurate diagnosis and management.

    Purpose of the Study:

    • To compare clinical manifestations, MRI findings, and immunological markers in early-onset MS versus adult-onset MS.
    • To identify potential diagnostic biomarkers for pediatric MS.
    • To elucidate the disease course and prognostic factors in early-onset MS.

    Main Methods:

    • Retrospective analysis of clinical data, MRI scans, and laboratory tests (blood and CSF).
    • Comparison of 19 early-onset MS patients with 100 adult-onset MS patients.

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  • Evaluation of immunological markers including albumin coefficient and free light chain concentrations.
  • Main Results:

    • Early-onset MS showed differences in sex ratio and initial symptoms, with higher rates of acute brainstem dysfunction and optic neuritis.
    • Tumor-like inflammatory lesions on MRI were more common in early-onset MS (29%).
    • Increased hematoencephalic barrier dysfunction (100% vs 50%) and elevated CSF kappa-free light chains (86% vs 99%) were observed in early-onset MS, confirming diagnostic value.

    Conclusions:

    • Early-onset MS exhibits distinct clinical and radiological characteristics, often with a more severe disease course.
    • Elevated kappa-free light chains in CSF are a valuable diagnostic marker for both early and adult-onset MS.
    • These findings can improve the diagnostic accuracy of MS in children.