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Published on: February 19, 2021
Pediatric multiple sclerosis: current concepts and consensus definitions
Joaquin A Pena1, Timothy E Lotze
1Baylor College of Medicine, Houston, TX 77030, USA.
Insights
Pediatric multiple sclerosis (MS) is an inflammatory central nervous system (CNS) disease increasingly diagnosed in children. This review highlights the unique features of childhood MS and advances in its diagnosis.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease affecting the central nervous system (CNS).
- While typically diagnosed in adults, MS is increasingly recognized in pediatric populations, accounting for 1.7%-5.6% of cases before age 18.
- Diagnosing MS in children presents challenges due to potential misdiagnosis and distinct clinical presentations compared to adults.
Purpose of the Study:
- To describe the distinctive features of pediatric demyelinating disorders, including MS.
- To summarize recent advances in the diagnosis and understanding of pediatric MS.
- To review the applicability of diagnostic criteria for childhood MS.
Main Methods:
- Literature review of recent advances in pediatric demyelinating disorders.
- Analysis of distinctive clinical, neuroimaging, and laboratory features in pediatric MS.
- Evaluation of diagnostic criteria, including the 2010 McDonald criteria, for pediatric MS.
Main Results:
- Pediatric MS exhibits unique clinical features, neuroimaging findings, laboratory results, and disease courses compared to adult MS.
- The 2010 McDonald criteria are proposed for diagnosing MS in children aged 12 and older.
- Accurate diagnosis in children can be challenging, often requiring differentiation from other neurological disorders.
Conclusions:
- Pediatric MS is a distinct entity with specific characteristics requiring tailored diagnostic approaches.
- Recent advances and updated criteria aid in the diagnosis of MS in children.
- Further research is needed to fully understand and manage pediatric demyelinating disorders.
Abstract:
Multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the central nervous system (CNS) commonly diagnosed in adults, is being recognized increasingly in children. An estimated 1.7%-5.6% of all patients with MS have clinical symptoms before reaching the age of 18 years. In comparison with adults, the diagnosis of MS in children can be more difficult, being dismissed or misdiagnosed as other clinical disorders. Although adults and children share basic aspects of the disorder, children have distinctive clinical features, neuroimaging, laboratory, and courses of the disease. The 2010 McDonald criteria have simplified the requirements for establishing the diagnosis of MS and have been proposed to be applicable for the diagnosis of pediatric MS, mainly in children 12 years and older. This paper describes the distinctive features of common pediatric demyelinating disorders, including MS, and summarizes the most recent advances based on the available literature.
