Pediatric Central Nervous System Demyelinating Diseases

This article provides an up-to-date summary of the categories, diagnosis, and management of pediatric demyelinating disorders.

Understanding of the diverse spectrum of pediatric demyelinating disorders, including monophasic and multiphasic forms, has improved. Pediatric multiple sclerosis (MS) is the most common demyelinating disorder in children, and recent genetic and environmental risk research has clarified that pediatric MS is on the same continuum of disease as adult MS. Recent advances in the treatment of pediatric MS include clinical trials leading to regulatory agency-approved treatments. The identification of myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies in children has been a major advance, allowing for appropriate treatment and management of these syndromes.

Antibody testing is now helping to define subtypes of pediatric demyelinating disorders, including myelin oligodendrocyte glycoprotein-seropositive and aquaporin-4-seropositive cases that are distinct from pediatric MS. Treatments for pediatric MS are being evaluated in clinical trials.