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Updated: Aug 12, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Clinical and MRI characteristics of multiple sclerosis in Iranian Children and Adolescents
Mohammad Mahdi Nasehi1,2, Ali Nikkhah1,2, Sasan Saket1,2
1Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Objective:
To determine the clinical and MRI characteristics of multiple sclerosis (MS) in the children and adolescents.
Material & Methods:
In this cross-sectional study, information of 95 MS patients was obtained from the Iranian MS registry. Disease characteristics and imaging data were collected using medical records.
Results:
Ninety-five patients including 64 female and 31 male subjects with mean age of 13.97±2.4 years (range, 8-18) years were enrolled. The most frequent signs and symptoms were ophthalmic symptoms (n=61, 64.2%), brainstem signs (n=44, 46.3%), cerebellar signs (n=32, 33.6%) and pyramidal signs (n=26, 27.3%). Blurred vision (n=21, 34.4%) was the most common ophthalmic symptom and ataxia (n=24, 75%) the most prevalent cerebellar sign. The most common brainstem signs/symptoms were motor symptoms and vertigo (each n=14, 31.8%) and the most common pyramidal sign/symptom was right upper monoparesis (n=14, 23.3%). Active demyelinating lesions were reported in brain MRI of all patients, mostly appeared as periventricular (n=91, 95.8%) and pericallosal (n=55, 57.9%) lesions. Acute demyelinating spinal lesions were presented in 38 patients (51.3%) with a prominent involvement of the cervical spine (n=33, 86.8%).
Conclusion:
In our study, the most frequent signs and symptoms were eye symptoms, brainstem signs, cerebellar signs and pyramidal signs, respectively. Moreover, our results showed that MRI plays a critical role in the diagnostic evaluation of MS in children with presence of brain lesions in all patients and spinal lesion in a considerable portion of patients.
Insights
Pediatric multiple sclerosis (MS) commonly presents with ophthalmic, brainstem, cerebellar, and pyramidal symptoms. Magnetic resonance imaging (MRI) is crucial for diagnosing MS in children, revealing brain lesions in all patients and spinal lesions in over half.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Pediatric-onset MS (POMS) accounts for a significant proportion of MS cases, presenting unique diagnostic and clinical challenges.
- Understanding the specific clinical and MRI characteristics of MS in children and adolescents is vital for accurate diagnosis and management.
Purpose of the Study:
- To elucidate the clinical manifestations and magnetic resonance imaging (MRI) findings in pediatric and adolescent patients diagnosed with multiple sclerosis.
- To characterize the common signs, symptoms, and lesion patterns observed in this specific demographic.
Main Methods:
- A cross-sectional study was conducted involving 95 patients diagnosed with MS, sourced from the Iranian MS registry.
- Clinical data, including signs and symptoms, were extracted from medical records.
- Brain and spinal MRI data were systematically collected and analyzed for lesion characteristics.
Main Results:
- The study included 95 patients (64 female, 31 male) with a mean age of 13.97 years.
- The most frequent symptoms were ophthalmic (64.2%), brainstem (46.3%), cerebellar (33.6%), and pyramidal (27.3%).
- All patients exhibited active demyelinating brain lesions on MRI, predominantly periventricular and pericallosal. Spinal lesions were present in 51.3% of patients, with a high prevalence in the cervical region.
Conclusions:
- Ophthalmic, brainstem, cerebellar, and pyramidal signs are the most common clinical presentations of MS in children and adolescents.
- MRI is indispensable in diagnosing pediatric MS, consistently identifying brain lesions and frequently detecting spinal lesions.
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