Related Experiment Video
Updated: May 16, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Long-term outcome of paediatric-onset multiple sclerosis: a population-based study
Katharine E Harding1, Kate Liang, Mark D Cossburn
1Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK.
Insights
Paediatric-onset multiple sclerosis (MS) patients experience a longer interval to their second relapse and develop secondary progressive MS later than adult-onset MS (AOMS) patients. Despite slower progression, POMS patients reach disability milestones at a younger age, suggesting a poorer long-term prognosis.
Area of Science:
- Neurology
- Clinical Medicine
- Epidemiology
Background:
- Multiple sclerosis (MS) onset typically occurs in adulthood, with paediatric-onset MS (POMS) being rare.
- Limited longitudinal data exists for POMS, hindering optimal management strategies.
- Understanding POMS outcomes is crucial for improving patient care.
Purpose of the Study:
- To compare the clinical features and disease progression of POMS with adult-onset MS (AOMS).
- To identify distinct phenotypic characteristics of POMS.
- To inform management strategies for POMS.
Main Methods:
- A prospective, population-based register was used to identify patients with MS onset before 18 years.
- Clinical data, including time to disability milestones (Expanded Disability Status Scale 4.0, 6.0, 8.0) and secondary progression, were collected.
- POMS patient data were compared with those of AOMS patients.
Main Results:
- 111 POMS patients were identified (5.4% of the total MS cohort).
- POMS patients had a longer interval to the second relapse and less primary progressive disease compared to AOMS.
- POMS patients reached disability milestones and developed secondary progression at older ages but did so at younger chronological ages than AOMS patients.
Conclusions:
- Paediatric-onset MS (POMS) represents a distinct phenotype with unique early disease characteristics.
- Although POMS progression is slower, reaching disability milestones at a younger age indicates a potentially poorer long-term prognosis.
- Management of POMS should consider these distinct characteristics and prognosis.
Background:
Age of onset of multiple sclerosis (MS) peaks in the 3rd and 4th decades and is rarely less than 18. Robust longitudinal studies in paediatric-onset MS (POMS) are limited, and a clearer understanding of outcome could optimise management strategies.
Methods:
Patients with disease onset <18 years were identified from a prospective population-based register. Clinical features including presenting symptoms, time to Expanded Disability Status Scale (EDSS) 4.0, 6.0 and 8.0 and onset of secondary progression were compared with patients with adult-onset MS (AOMS).
Results:
111 POMS patients were identified from a cohort of 2068. No significant differences in sex ratio, familial recurrence, relapse rate, ethnicity or clinical symptoms at presentation were identified between POMS and AOMS. However, interval to second relapse was longer (5 vs 2.6 years, p=0.04) and primary progressive disease was less common (0.9% vs 8.5%, p=0.003) in POMS than in AOMS. POMS patients also took longer to develop secondary progressive disease (32 vs 18 years, p=0.0001) and to reach disability milestones (EDSS 4.0, 23.8 vs 15.5 years, p<0.0001; EDSS 6.0, 30.8 vs 20.4 years, p<0.0001; EDSS 8.0, 44.7 vs 39 years, p=0.02), but did so between 7.0 and 12 years younger than in AOMS.
Conclusions:
5.4% of patients with MS have POMS (2.7% <16 years; 0.3% <10 years) and have distinct phenotypic characteristics in early disease. Furthermore, while patients with POMS take longer to reach disability milestones, they do so at a younger age than their adult counterparts and could be considered to have a poorer prognosis. Management strategies for these patients should take account of these data.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
02:20Longitudinal Research
01:26Longitudinal Studies