Related Experiment Videos
Multiple sclerosis in childhood: clinical features of 149 cases
A Ghezzi1, V Deplano, J Faroni
1Centro Studi Sclerosi Multipla-Ospedale di Gallarate, Università di Milano, Italy.
Abstract:
From the retrospective study of 3375 patients affected by clinically definite or probable multiple sclerosis (MS), 149 patients were collected with onset of the disease before the age of 16 years (4.4%). Female/male ratio was higher than that of the adult onset MS (AOMS) population (2.2 vs 1.6) particularly at ages of onset after 12 years (3.0, P = 0.007 vs AOMS). Among initial symptoms, those suggesting brainstem dysfunction (25%) were more frequent compared to other systems and compared to AOMs symptoms; motor and sensory disturbances were slightly less frequent (respectively 17.5% and 18.3%). Optic neuritis appeared in 16.5% of cases with onset in childhood and in 16.2% of cases with AOMS, cerebellar disturbances respectively in 9.1% and 7.7%. The first interattack-interval and the clinical course of early onset MS did not differ significantly from AOMS. In early onset MS patients with disease duration < 8 years, cases with EDSS > 6 were slightly more frequent than in the AOMS group (P = 0.04). The frequency of cases for different levels of disability was similar for disease duration > 8 years.
Insights
Pediatric multiple sclerosis (MS) shows a higher female-to-male ratio and more frequent initial brainstem symptoms compared to adult-onset MS. However, clinical course and disability progression are similar in the long term.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Early-onset MS (EOMS), defined as onset before age 16, represents a significant subset of MS patients.
- Understanding the specific characteristics of EOMS is crucial for diagnosis and management.
Purpose of the Study:
- To compare the clinical features, initial symptoms, and disease course of EOMS with adult-onset MS (AOMS).
- To investigate potential differences in gender distribution and early disability progression between EOMS and AOMS.
Main Methods:
- Retrospective analysis of 3375 MS patients, identifying 149 with EOMS.
- Comparison of demographic data, initial symptoms, and clinical course between EOMS and AOMS cohorts.
- Assessment of disability using the Expanded Disability Status Scale (EDSS) at different disease durations.
Main Results:
- EOMS exhibited a higher female/male ratio (2.2 vs 1.6) compared to AOMS, particularly in those with onset after age 12.
- Brainstem dysfunction was a more frequent initial symptom in EOMS (25%) than in AOMS.
- No significant differences were observed in the first interattack interval or overall clinical course between EOMS and AOMS.
- Early in the disease course (duration < 8 years), EOMS patients showed a slightly higher frequency of significant disability (EDSS > 6).
Conclusions:
- EOMS presents distinct demographic and initial symptom profiles compared to AOMS.
- Despite early differences, the long-term clinical course and disability progression in EOMS are comparable to AOMS.
- Further research into the specific mechanisms and long-term outcomes of EOMS is warranted.