Multiple sclerosis in childhood: report of 16 cases

Sixteen children with definite multiple sclerosis (MS; aged 6-17 years, mean 11.4 +/- 2.7; 8 boys, 8 girls) were reviewed. Cerebellar symptoms and signs were frequent at initial presentation. Among laboratory studies, the cerebrospinal fluid (CSF) IgG index or oligoclonal bands were informative in 75%, evoked potentials in 70%, electroencephalography (EEG) in 83%, magnetic resonance imaging in 80% and computed tomography in 45%. When compared with patients with other neurological disorders and similar presentation (non-MS group, n = 13), MS patients were more likely to recover from the first attack without significant sequelae. CSF protein was usually normal in MS and high in non-MS patients. The CSF IgG index and/or oligoclonal bands were also helpful in differentiating these two groups. The absence of female preponderance, the frequency of EEG abnormalities and the lower yield from CSF analysis are particularly interesting in this childhood series. Different pathogenetic mechanisms may be involved in MS from different ages, genetic backgrounds, or environments.