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Published on: February 19, 2021
Consensus definitions for pediatric MS and other demyelinating disorders in childhood
Marc Tardieu1, Brenda Banwell2, Jerry S Wolinsky2
1From the National Reference Center for Inflammatory Diseases of the Brain (M.T.), Hôpitaux Universitaires Paris-Sud, University Paris-Sud, France; Perelman School of Medicine (B.B.), The Children's Hospital of Philadelphia, University of Pennsylvania; University of Texas Health Science Center at Houston (J.W.); Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; and Lourie Center for Pediatric MS (L.B.K.), Stony Brook Children's, NY. marc.tardieu@bct.aphp.fr.
Insights
Pediatric multiple sclerosis (MS) diagnosis is evolving with updated criteria. This review summarizes diagnostic applications and proposes new definitions for disease activity and treatment response in children with acquired central nervous system demyelination.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Demyelinating Diseases
Background:
- The 2012 International Pediatric Multiple Sclerosis Group (IPMSSG) established definitions for pediatric multiple sclerosis (MS) and related disorders.
- Pediatric-onset MS is now incorporated into the 2010 McDonald criteria for MS diagnosis.
- New therapeutic options and clinical trials necessitate updated definitions for disease activity and treatment response.
Purpose of the Study:
- To review and summarize the application of current diagnostic criteria for pediatric MS.
- To discuss the inclusion of pediatric-onset MS within the 2010 McDonald criteria.
- To propose definitions for "no evidence of disease activity" and "inadequate treatment response" in pediatric demyelinating disorders.
Main Methods:
- Literature review of the 2012 IPMSSG definitions.
- Analysis of the 2010 McDonald criteria regarding pediatric MS.
- Synthesis of proposals for new clinical definitions.
Main Results:
- The 2010 McDonald criteria facilitate the diagnosis of MS in children.
- Updated definitions are crucial for managing pediatric MS effectively.
- The review highlights the need for standardized measures of disease activity and treatment efficacy.
Conclusions:
- Current diagnostic criteria, including the 2010 McDonald criteria, are applicable to children with acquired central nervous system demyelination.
- Formalizing definitions for "no evidence of disease activity" and "inadequate treatment response" is essential for advancing pediatric MS care and research.
Abstract:
In light of the published 2012 International Pediatric Multiple Sclerosis Group definitions for pediatric multiple sclerosis (MS) and related disorders and given that pediatric-onset MS is now formally included in the 2010 McDonald criteria for MS, we sought to review these criteria and summarize their application in children with acquired CNS demyelination. In addition, proposals are made for definitions of no evidence of disease activity and inadequate treatment response that are important because of new therapeutic options and trials.
