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Published on: February 19, 2021
Paediatric Multiple Sclerosis: Update on Diagnostic Criteria, Imaging, Histopathology and Treatment Choices
I-Jun Chou1,2,3, Huei-Shyong Wang3, William P Whitehouse2
1Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
Insights
Paediatric multiple sclerosis (MS) requires accurate diagnosis and treatment to prevent disability. Early differentiation from similar conditions like ADEM and NMOSD is crucial for effective management in children.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Paediatric multiple sclerosis (MS) affects <5% of MS patients.
- Early-onset MS leads to disability at a younger age.
- Accurate diagnosis and treatment are vital to mitigate neuroinflammation and neurodegeneration.
Purpose of the Study:
- To summarize updated diagnostic criteria for paediatric MS.
- To review imaging and histopathology findings.
- To discuss current treatment options for paediatric MS.
Main Methods:
- Literature review of recent studies on paediatric MS.
- Analysis of diagnostic criteria evolution.
- Synthesis of imaging and histopathology data.
- Evaluation of treatment strategies.
Main Results:
- Paediatric MS diagnosis can be challenging due to atypical presentations.
- Differentiating paediatric MS from ADEM and NMOSD requires careful evaluation.
- Updated diagnostic criteria aim to improve early identification.
- Treatment strategies focus on reducing inflammation and neurodegeneration.
Conclusions:
- Early and accurate diagnosis of paediatric MS is critical.
- Distinguishing MS from ADEM and NMOSD in children is essential for appropriate care.
- Optimal treatment is key to improving long-term outcomes for children with MS.
Abstract:
Paediatric multiple sclerosis (MS) represents less than 5 % of the MS population, but patients with paediatric-onset disease reach permanent disability at a younger age than adult-onset patients. Accurate diagnosis at presentation and optimal long-term treatment are vital to mitigate ongoing neuroinflammation and irreversible neurodegeneration. However, it may be difficult to early differentiate paediatric MS from acute disseminated encephalomyelitis (ADEM) and neuromyelitis optica spectrum disorders (NMOSD), as they often have atypical presentation that differs from that of adult-onset MS. The purpose of this review is to summarize the updated views on diagnostic criteria, imaging, histopathology and treatment choices.
