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Paediatric-onset multiple sclerosis: demographics, symptoms and disease progression
David Ellenberger1, Peter Flachenecker2, Judith Haas3
1German MS Register, MS Forschungs- und Projektentwicklungs- gGmbH, Hannover, Germany ellenberger@msregister.de.
Journal of Neurology, Neurosurgery, and Psychiatry
|September 8, 2025
Summary
Paediatric-onset multiple sclerosis (POMS) affects more women and presents differently than adult-onset MS (AOMS). While POMS patients experience higher relapse rates initially, they may achieve a more stable disease course later in life.
Area of Science:
- Neuroimmunology
- Clinical Neurology
Background:
- Multiple sclerosis (MS) is a leading neuroimmunological condition affecting young adults.
- Limited data exist on paediatric-onset MS (POMS), defined as onset before age 18.
Purpose of the Study:
- To compare paediatric-onset MS (POMS) with adult-onset MS (AOMS) regarding diagnostic delay, initial symptoms, and long-term outcomes.
- To identify predictors of disease progression in POMS.
Main Methods:
- Observational study of over 1000 POMS cases compared to AOMS.
- Analysis using generalized additive models, adjusting for confounders.
Main Results:
- POMS shows a diagnostic delay and a higher proportion of female patients compared to AOMS.
- Common POMS symptoms include sensory and visual disturbances; relapse rates are higher in POMS within the first 15 years.
- POMS patients exhibit a plateau in disability progression after age 40, leading to similar long-term disability scores as AOMS.
Conclusions:
- This study, the largest and longest follow-up of POMS, indicates women are more prone to developing MS at younger ages.
- POMS patients may recover faster from relapses and experience a more stable disease course in later life compared to AOMS.
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