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Multiple sclerosis in children under 10 years of age
M Ruggieri1, P Iannetti, A Polizzi
1Institute of Neurological Science, National Research Council, Viale R. Margherita 6, I-95125 Catania, Italy. m.ruggieri@isn.cnr.it
Insights
Pediatric multiple sclerosis (MS) is often underestimated, occurring even in infants. Early-onset MS (<10 years) requires specific diagnostic and management guidelines due to unique clinical and radiographic features.
Area of Science:
- Neurology
- Pediatrics
Background:
- Multiple sclerosis (MS) is increasingly recognized in children, yet often viewed as a young adult disease.
- Early-onset MS (before age 10) may be underdiagnosed, necessitating specific clinical considerations.
- Current diagnostic criteria for MS are not fully validated for the pediatric population, particularly for very young children.
Purpose of the Study:
- To review the literature on early-onset multiple sclerosis (MS).
- To highlight the unique characteristics of MS presenting in children under 10 years of age.
- To summarize preliminary findings from the Italian Society of Pediatric Neurology (SINP) national registry for early-onset MS.
Main Methods:
- Literature review on childhood multiple sclerosis.
- Analysis of preliminary data from the SINP national registry.
- Focus on patients with disease onset before 10 years of age.
Main Results:
- Early-onset MS (<10 years) presents distinct clinical and radiographic features.
- The Italian national registry provides preliminary insights into this understudied group.
- Existing diagnostic criteria may require adaptation for very young MS patients.
Conclusions:
- Multiple sclerosis can occur in infancy and pre-school ages, challenging the perception of it being solely a young adult disease.
- Specific parameters for diagnosis, therapy, and education are needed for early-onset pediatric MS.
- Further research and registry data are crucial for understanding and managing MS in the youngest patients.
Abstract:
Despite the consistent amount of information accumulated in recent years on multiple sclerosis (MS) in childhood, many clinicians still view this condition as an exclusively young adult-onset disease and do not consider that it may occur and manifest even during infancy and pre-school age, suggesting that the number of MS cases in the paediatric age group may have been underestimated. Thus, the need to have practical parameters for therapeutic, counselling and educational purposes in such settings as caring for patients whose onset of disease is at very early ages may increasingly arise for practising clinicians. In addition, the clinical and radiographic criteria for the diagnosis of MS have not been validated in a paediatric MS population; accordingly, inclusion age at onset (such as for research purposes) is generally over 10 years. To highlight the peculiarities that characterise MS when it begins at this young age we have reviewed the literature and summarised our preliminary results with the national registry of the Italian Society of Paediatric Neurology (SINP) Study Group on Childhood MS in the group of MS patients with the earliest onset of disease (i.e., <10 years of age).
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