Related Experiment Video
Updated: Feb 26, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Characteristics of pediatric multiple sclerosis: The Turkish pediatric multiple sclerosis database
Ünsal Yılmaz1, Banu Anlar2, Kıvılcım Gücüyener3
1Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Insights
Pediatric multiple sclerosis (MS) in Turkey commonly affects the brainstem and cerebellum, with early-onset MS showing distinct characteristics. Visual evoked potential abnormalities are frequent, even without optic neuropathy history.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Pediatric multiple sclerosis (MS) is a rare autoimmune disease affecting the central nervous system.
- Understanding the specific clinical and paraclinical features of pediatric MS in different geographic regions is crucial for diagnosis and management.
Purpose of the Study:
- To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey.
- To compare the characteristics of early-onset (<12 years) versus later-onset (≥12 years) pediatric MS.
Main Methods:
- A retrospective study collected data from 193 MS patients with onset before age 18 from 27 Turkish pediatric neurology centers.
- Patients were categorized into earlier-onset (<12 years) and later-onset (≥12 years) groups for comparison.
Main Results:
- The study included 193 patients (63.7% female), with a median age of 14 at onset. Common initial symptoms included polysymptomatic presentation (55.4%), brainstem syndromes (50.3%), and sensory disturbances (44%).
- Magnetic resonance imaging (MRI) revealed frequent periventricular (96%) and spinal cord (67%) involvement. Abnormal visual evoked potentials (VEP) were found in 52% of patients, and low vitamin D levels in 68.5%.
- Early-onset MS was associated with a higher rate of preceding infections/vaccinations, initial diagnosis of acute disseminated encephalomyelitis (ADEM), longer intervals between attacks, and faster disability accumulation.
Conclusions:
- The brainstem and cerebellum are common sites of clinical and radiological involvement in pediatric-onset MS.
- VEP abnormalities are prevalent, irrespective of optic neuropathy history, and vitamin D status may not influence early disease course.
- MS onset before 12 years of age presents with specific historical and clinical characteristics.
Objective:
To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey.
Methods:
Data of MS patients with onset before age 18 years (n = 193) were collected from 27 pediatric neurology centers throughout Turkey. Earlier-onset (<12 years) and later-onset (≥12 years) groups were compared.
Results:
There were 123 (63.7%) girls and 70 (36.3%) boys aged 4-17 years, median 14 years at disease onset. Family history of MS was 6.5%. The first presentation was polysymptomatic in 55.4% of patients, with brainstem syndromes (50.3%), sensory disturbances (44%), motor symptoms (33.2%), and optic neuritis (26.4%) as common initial manifestations. Nineteen children had facial paralysis and 10 had epileptic seizures at first attack; 21 (11%) were initially diagnosed with acute disseminated encephalomyelitis (ADEM). Oligoclonal bands were identified in 68% of patients. Magnetic resonance imaging revealed periventricular (96%), cortical/juxtacortical (64.2%), brainstem (63%), cerebellum (51.4%), and spinal cord (67%) involvement. Visual evoked potentials (VEP) were abnormal in 52%; serum 25-hydroxyvitamin D levels were low in 68.5% of patients. The earlier-onset group had a higher rate of infection/vaccination preceding initial attack, initial diagnosis of ADEM, longer interval between first 2 attacks, and more disability accumulating in the first 3 years of the disease.
Conclusion:
Brainstem and cerebellum are common sites of clinical and radiological involvement in pediatric-onset MS. VEP abnormalities are frequent even in patients without history of optic neuropathy. Vitamin D status does not appear to affect the course in early disease. MS beginning before 12 years of age has certain characteristics in history and course.
More Related Videos
09:18Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
07:20Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
