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Pediatric inflammatory diseases. Part I: multiple sclerosis

A Catalucci1, M Anselmi, A Splendiani

  • 1Chair and Unit of Neuroradiology, University of L'Aquila; L'Aquila, Italy - massimo.gallucci@cc.univaq.it.

The Neuroradiology Journal
|September 14, 2013
PubMed

Insights

Pediatric multiple sclerosis (PMS) affects children and adolescents, presenting similarly to adult MS but often with a more aggressive course. Diagnosis requires demonstrating demyelination over time and space, with MRI crucial for distinguishing it from ADEM.

Area of Science:

  • Neurology
  • Pediatrics
  • Immunology

Background:

  • Multiple sclerosis (MS) is an inflammatory central nervous system (CNS) disease.
  • It typically affects young adults but also occurs in children and adolescents.
  • Pediatric MS (PMS) diagnosis mirrors adult criteria, requiring evidence of demyelination over time and space.

Purpose of the Study:

  • To summarize the characteristics of pediatric multiple sclerosis.
  • To highlight diagnostic challenges and considerations in pediatric MS.
  • To differentiate PMS from acute disseminated encephalomyelitis (ADEM).

Main Methods:

  • Review of diagnostic criteria for pediatric MS.
  • Analysis of clinical and imaging features specific to PMS.
  • Comparison of PMS with adult MS and ADEM.

Main Results:

  • PMS can exhibit a more aggressive disease course than adult MS.
  • Atypical imaging findings, such as giant and pseudotumoral plaques, are observed in PMS.
  • Differential diagnosis between PMS and ADEM can be challenging, often necessitating MRI follow-up.

Conclusions:

  • Pediatric MS shares diagnostic criteria with adult MS but presents unique clinical and imaging features.
  • The aggressive nature and atypical presentations of PMS require careful diagnostic evaluation.
  • Magnetic resonance imaging (MRI) plays a critical role in the diagnosis and management of pediatric MS, especially in differentiating it from ADEM.

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