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Updated: Jun 28, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Multiple sclerosis in childhood: clinical and radiological features
Michael B Forrester1, Lee Coleman, Andrew J Kornberg
1Department of Neurology Royal Children's Hospital, Melbourne, Australia.
Insights
Early onset multiple sclerosis in children presents with optic neuritis and pyramidal dysfunction. Treatment with immunomodulatory therapy reduced relapse rates, indicating its efficacy in managing pediatric multiple sclerosis.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Early onset multiple sclerosis (EOMS) is a rare demyelinating disease in children.
- Understanding EOMS clinical and neuroimaging features is crucial for early diagnosis and management.
- Comparing EOMS with acute demyelinating encephalomyelitis (ADEM) and adult multiple sclerosis (MS) aids in differential diagnosis.
Purpose of the Study:
- To analyze the clinical and neuro-radiological characteristics of pediatric multiple sclerosis.
- To compare these features with ADEM and adult MS.
- To evaluate the efficacy of immunomodulatory therapy in EOMS.
Main Methods:
- Retrospective analysis of medical records and cerebral imaging in 30 children with EOMS.
- Comparison of clinical and radiological findings with ADEM and adult MS cohorts.
- Assessment of Expanded Disability Status Scale (EDSS) scores and relapse rates.
- Evaluation of treatment outcomes with immunomodulatory therapies.
Main Results:
- The female to male ratio in EOMS was 1.3 before age 12, increasing to 4.3 after age 12.
- Common presenting symptoms included optic neuritis and pyramidal dysfunction.
- Radiological findings revealed periventricular lesions, corpus callosal demyelination, gadolinium enhancement, and Dawson's fingers.
- Median relapse rate was 1.2 per patient-year, with EDSS score increasing by 0.7 per relapse.
- Immunomodulatory therapy (Interferon beta 1a, Interferon beta 1b, Glatiramer acetate) was initiated in 10 patients, showing minimal side effects and reduced relapse rates.
Conclusions:
- EOMS exhibits distinct clinical and radiological patterns in children.
- Early diagnosis and intervention with immunomodulatory therapies can effectively manage EOMS, reducing relapse rates and disability progression.
- Further research is warranted to elucidate long-term outcomes and optimal treatment strategies for pediatric MS.
Abstract:
We analyzed the medical records and cerebral imaging of 30 children with early onset multiple sclerosis to compare the clinical and neuro-radiological features with acute demyelinating encephalomyelitis and adult multiple sclerosis. The female:male ratio was 1.3 before the age of 12 years and increased to 4.3 after age 12 years. Optic neuritis and pyramidal dysfunction were the most common presenting clinical features. The most common radiological features at first imaging were periventricular (77.2%), corpus callosal demyelination (63.6%), gadolinium enhancement (62.5%), and Dawson's fingers (40.9%). The median relapse rate per patient year was 1.2 ([IQR] 0.6-2.0). Seven patients reached a moderate Expanded-Disability-Status-Scale score of 3 and 3 patients were more severely affected (score of 6). Expanded-Disability-Status-Scale score increased by 0.7 for every relapse. Ten patients were commenced on immunomodulatory therapy (Interferon beta 1a, n = 9; Interferon beta 1b, n = 3; or Glatiramer acetate, n = 1), the majority of who had minimal side effects and a reduction in relapse rate.
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