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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Pediatric Multiple Sclerosis
Alexandra B Kornbluh1, Ilana Kahn1
1Children's National Hospital, Washington, DC; George Washington School of Medicine and Health Sciences, Washington, DC.
Insights
Pediatric onset multiple sclerosis (POMS) has specific diagnostic criteria and imaging roles. POMS indicates a more inflammatory disease course, prompting earlier use of effective disease-modifying therapies (DMTs).
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Pediatric onset multiple sclerosis (POMS) presents unique diagnostic and management challenges.
- The McDonald criteria require careful evaluation for accuracy in pediatric populations.
- Understanding POMS prognosis is crucial for timely and effective treatment.
Purpose of the Study:
- To summarize current diagnostic criteria for POMS.
- To review the utility of MRI, bloodwork, and cerebrospinal fluid studies in POMS diagnosis.
- To discuss the prognostic implications and emerging treatment strategies for POMS.
Main Methods:
- Review of current diagnostic criteria for POMS.
- Analysis of MRI performance in pediatric multiple sclerosis diagnosis.
- Evaluation of bloodwork and CSF studies for ruling out POMS mimics.
- Assessment of POMS prognosis compared to adult-onset MS.
- Overview of current and investigational disease-modifying therapies (DMTs) for POMS.
Main Results:
- The McDonald criteria show performance in the pediatric population.
- MRI plays a key role in POMS diagnosis and research.
- Bloodwork and CSF are vital for excluding other conditions.
- POMS is associated with a more inflammatory disease course and earlier disability.
- Earlier initiation of highly effective DMTs is becoming standard practice.
Conclusions:
- Accurate diagnosis of POMS relies on updated criteria and appropriate investigations.
- POMS requires aggressive management due to its inflammatory nature and prognosis.
- Early immunomodulatory treatment is essential for controlling POMS and improving outcomes.
Abstract:
The current diagnostic criteria for pediatric onset multiple sclerosis (POMS) are summarized, as well as the evidence for performance of the most recent iteration of McDonald criteria in the pediatric population. Next, the varied roles of MRI in POMS are reviewed, including diagnostic considerations and research-based utilization. The primary role of bloodwork and cerebrospinal fluid studies in the diagnosis of POMS is to rule out disease mimics. Prognostically, POMS portends a more inflammatory course with higher relapse rate and disability reached at younger ages compared with AOMS counterparts. As such, there is an emerging trend toward the earlier use of highly efficacious disease modifying therapies to target prompt immunomodulatory disease control. Current POMS disease modifying therapies (DMTs) and active clinical POMS trials are detailed.
