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The course of early-onset multiple sclerosis in Iraqi children
Hasan A Al-Hamadani1, Atheer S Abdalla, Atheer J Al-Saffar
1Department of Medicine/Neurology, College of Medicine, Al-Nahrain University, Baghdad, Iraq.
Insights
Pediatric multiple sclerosis (MS) in Iraq appears more aggressive than in other countries, with most young patients experiencing a relapsing-remitting course. Further research is needed to confirm these findings on pediatric MS progression.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Multiple sclerosis (MS) is a growing global concern in pediatric populations.
- Understanding the clinical characteristics of early-onset MS is crucial for effective management.
Purpose of the Study:
- To identify the clinical characteristics of multiple sclerosis (MS) with onset in individuals under 18 years of age.
- To analyze the disease course and progression in pediatric MS patients in Iraq.
Main Methods:
- A cross-sectional study reviewed 1125 MS patient records from 2000-2008.
- Data from 77 pediatric MS patients (onset <18 years) were analyzed.
Main Results:
- The mean age of onset was 14.95 years, with a female predominance (1.6:1 ratio).
- Most patients (90.9%) presented with relapsing-remitting MS, and 12.9% progressed to secondary progressive MS.
- A significant inverse correlation was found between the progression index and the interval between the first two attacks (P=0.0001).
Conclusions:
- Pediatric MS in Iraq may follow a more aggressive clinical course compared to other regions.
- Further research is warranted to validate these observations and explore contributing factors.
Background:
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that is increasingly recognized worldwide in children and adolescents. The current study aimed at identifying the clinical characteristics of MS with onset under 18 years of age.
Methods:
This cross-sectional study was conducted in the Multiple Sclerosis Center archive system in Baghdad Teaching Hospital during the period from March 1 to May 15, 2008. The records of 1125 MS patients from 2000 to 2008 were reviewed. Among them 77 patients had the onset of MS under 18 years of age.
Results:
Two thirds of the patients were female (a female/male ratio of 1.6:1). The mean age of the patients at the onset of the disease was 14.95 ± 3.21 years, and the mean time between the first and second attacks was 3.06 ± 4.09 years. Seventy patients (90.9%) had an initial course of relapse remitting MS. Among them 9 (12.9%) progressed to secondary progressive MS after a mean duration of 9.87 ± 4.14 years. The remaining 7 patients had primary progressive MS associated with optic neuritis and brain stem lesion. Fifty-nine (76.6%) patients had monofocal signs and 18 (23.4%) had polyfocal signs. The mean extended disability status scale score was 4.15 ± 2.17 and the mean progression index was 1.44 ± 2.31. There was a strong inversed correlation between the progression index and interval between the first and second attacks (P=0.0001).
Conclusions:
The results of the present study show that the course of MS in Iraqi children and adolescents is more aggressive than in children from other countries. This finding needs to be evaluated by further studies.
