1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-1-25 10.15844/pedneurbriefs-1-4-4 Demyelinating Diseases Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Multtple Sclerosis http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 09 1987 01 08 2016 1 4 25 26 Copyright: © 1987 The Author(s) 1987 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Multiple sclerosis in childhood: clinical profile in 125 patients

Nine MS clinics from the Canadian MS study group collaborated in a retrospective study employing questionnaires about the MS populations and with particular reference to cases with onset before age 16 years.

 Nonprogressive Clinical Course Lower Disability Scores Progressive Course

Nine MS clinics from the Canadian MS study group collaborated in a retrospective study employing questionnaires about the MS populations and with particular reference to cases with onset before age 16 years. Childhood MS was more frequent in girls and their overrepresentation was even greater in the following subgroups: those with sensory initial symptoms, complete recovery from initial episode, a nonprogressive clinical course, and lower disability scores. Conversely, boys were overrepresented in subgroups of patients with no recovery from the initial episode and progressive course.

MS in girls has an early onset, is usually heralded by sensory symptoms that frequently remit completely, has a relapsing-remitting course and a slow progression. Boys with MS have a poorer prognosis and progressive course, usually related to late onset of the disease. The familial incidence was 28%. CSF showed normal IgG levels in 59% and abnormal oligoclonal bands in 82%. [1]

COMMENT: MS is probably more common in children than we suspect and the diagnosis should be considered especially in girls with initial sensory or visual symptoms that remit completely and later evolve in a relapsing-remitting manner. An onset at 2 years of age is the earliest case report [2]. The abrupt rise in incidence that coincides with puberty may be related to hormonal factors. Analysis of data from a Faroe Island epidemic of MS suggested a 2-stage process in the pathogenesis of MS: 1) acquisition of an exogenous factor such as infection and 2) the onset of host factors related to pubescence that allow the pathogenesis to proceed [3].

Oligoclonal bands in the CSF are the best single laboratory test for the presence of abnormal IgG in patients suspected of having MS. A combination of oligoclonal band and IgG synthesis tests is 97% sensitive for probable and definite MS [4]. NMR imaging differentiates between gray and white matter and is superior to CT in the diagnosis of MS. [5]

 Duquette P Murray TJ Pleines J Ebers GC Sadovnick D Weldon P Multiple sclerosis in childhood: clinical profile in 125 patients J Pediatr 1987 Sep 111 3 359 63 3625402 10.1016/S0022-3476(87)80454-7 Bejar JM Ziegler DK Onset of multiple sclerosis in a 24-month-old child Arch Neurol 1984 Aug 41 8 881 2 6466164 Fischman HR Multiple sclerosis: a two-stage process? Am J Epidemiol 1981 Aug 114 2 244 52 7304559 Bloomer LC Bray PF Relative value of three laboratory methods in the diagnosis of multiple sclerosis Clin Chem 1981 Dec 27 12 2011 3 7307253 Young IR Hall AS Pallis CA Legg NJ Bydder GM Steiner RE Nuclear magnetic resonance imaging of the brain in multiple sclerosis Lancet 1981 Nov 14 2 8255 1063 6 6118521 10.1016/S0140-6736(81)91273-3