Pediatric-Onset Multiple Sclerosis Disease Progression in Kuwait: A Retrospective Analysis

Area of Science:

• Neurology
• Pediatric Neurology
• Autoimmune Diseases

Background:

• Multiple sclerosis (MS) affects both pediatric and adult populations, sharing fundamental characteristics.
• However, distinct clinical presentations and disease trajectories are observed in pediatric MS patients.

Purpose of the Study:

• To conduct a comparative analysis of demographic and clinical features between pediatric-onset and adult-onset multiple sclerosis.
• To identify key differences in disease course and progression between these two cohorts.

Main Methods:

• Utilized the Kuwait National Multiple Sclerosis Registry to identify patients with disease onset at age ≤17 years (pediatric) or >17 years (adult).
• Analyzed demographic data and clinical characteristics, including disability measures and time to secondary progressive MS.
• Employed chi-square and Student t tests for cohort comparisons.

Main Results:

• Assessed 984 MS records; 111 (11.3%) had pediatric onset (mean age 14.9 years) versus adult onset (mean age 27.68 years).
• Pediatric-onset MS patients showed a higher likelihood of brainstem/cerebellar and multifocal presentations (P < 0.03 and P < 0.01, respectively).
• Pediatric-onset MS patients had lower Expanded Disability Status Scale scores (2.38 vs. 3.02, P = 0.003) and a longer time to secondary progressive MS (14.6 vs. 11.0 years, P < 0.04).

Conclusions:

• Pediatric-onset multiple sclerosis is associated with specific initial symptoms, including brainstem/cerebellar and multifocal presentations.
• Despite comparable relapse rates, pediatric MS demonstrates a more favorable long-term prognosis with reduced disability accumulation and delayed progression to secondary progressive MS.