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Published on: February 19, 2021
Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central
E Daniëlle van Pelt1, Rinze F Neuteboom1, Immy A Ketelslegers1
1Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
Insights
The 2012 International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions enable earlier and reliable diagnosis of paediatric multiple sclerosis (MS). This facilitates timely patient counseling and treatment initiation for children with acquired demyelinating syndromes (ADS).
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Revised diagnostic criteria for immune-mediated acquired demyelinating syndromes (ADS) in children were established by the International Paediatric Multiple Sclerosis Study Group (IPMSSG).
- These revisions impact the diagnosis of pediatric multiple sclerosis (MS), a significant neurological condition in children.
Purpose of the Study:
- To validate the efficacy of the 2012 revised IPMSSG consensus definitions.
- To assess the diagnostic performance in a prospective cohort of pediatric patients with ADS.
Main Methods:
- Children diagnosed with ADS and undergoing MRI within 90 days of symptom onset were enrolled.
- Sensitivity and specificity of the 2007 and 2012 IPMSSG definitions were compared.
- Time to MS diagnosis using both definition sets was analyzed via survival analysis.
Main Results:
- Eighty-two children with ADS were included; 35 were diagnosed with pediatric MS.
- The 2012 definitions demonstrated 80% sensitivity and 100% specificity.
- MS diagnosis occurred 3.4 months earlier with the 2012 definitions, with 14 diagnoses made at the first MRI.
Conclusions:
- The 2012 IPMSSG consensus definitions allow for reliable and early diagnosis of pediatric MS.
- Early diagnosis supports improved counseling for affected children and their families.
- Timely diagnosis enables prompt initiation of appropriate treatment strategies.
Background:
Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised.
Objective:
To evaluate the 2012 revised IPMSSG consensus definitions in a cohort of children with ADS prospectively followed from January 2007.
Methods:
Children with ADS who had an MRI scan obtained within 90 days after first disease onset were included. The sensitivity and specificity of the 2007 and 2012 IPMSSG consensus definitions were assessed. The time to MS diagnosis applying the 2007 and 2012 definitions was compared using survival analysis and log-rank test.
Results:
82 children with ADS were included. 35 children were diagnosed with paediatric MS, of whom 30 experienced a second clinical event. The final diagnosis corresponded applying either the 2007 or 2012 IPMSSG definitions. The revised 2012 definitions had sufficient sensitivity (80%) and high specificity (100%). MS diagnosis was made 3.4 months earlier (χ(2)=8.24, p=0.004) applying the new definitions. In 14 children, MS diagnosis was made at first MRI.
Conclusions:
MS diagnosis can be made reliable and early using the 2012 IPMSSG consensus definitions. This is beneficial for adequate counselling of children and their families and for early treatment possibilities.
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