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-11-91-b 10.15844/pedneurbriefs-11-12-5 Demyelinating Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Optic Neuritis and Risk of Multiple 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 12 1997 01 05 2016 11 12 91 92 Copyright: © 1997 The Author(s) 1997 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. Risk factors for developing multiple sclerosis after childhood optic neuritis

Risk factors for the development of multiple sclerosis (MS) were determined by follow-up (mean 22 yrs) of 79 children who presented with a diagnosis of optic neuritis (ON) at the Mayo Clinic between 1950 and 1988.

 Multiple Sclerosis Optic Neuritis Bilateral Sequential

Risk factors for the development of multiple sclerosis (MS) were determined by follow-up (mean 22 yrs) of 79 children who presented with a diagnosis of optic neuritis (ON) at the Mayo Clinic between 1950 and 1988. The incidence of MS was 13% by 10 yrs follow-up and 19% by 20 yrs. Of the patients who developed MS, 7 of 15 (47%) had symptoms within the first year after recovery from ON; one developed MS after 31 years interval. Four had clinical signs of Devic’s disease. Bilateral sequential or recurrent ON increased the risk of MS, whereas unilateral ON was associated with a low risk of MS. Of 37 children with unilateral ON, only 2 (5%) developed MS. The presence of recent infection within 2 weeks of onset of ON decreased the risk of MS. Childhood onset ON had a lower risk of progression to MS compared to ON in adults. [1]

COMMENT. The risk of developing multiple sclerosis after optic neuritis in childhood is lower than in adult-onset ON and increases with length of follow-up from 13% after 10 years to 22% by 30 years. Bilateral ON carries a greater risk of MS, whereas infection preceding the ON lessens the risk of MS.

In a previous report from Gottingen, Germany (Hanefeld FA, 1995), onset or relapse of MS was preceded by a nonspecific infection, usually an URI, in >50% cases. Of 8 presenting with ON, 4 developed MS within 2 years. (See Progress in Pediatric Neurology III, PNB Publ, 1997;551-554, for further articles on childhood MS).

Lucchinetti CF Kiers L O’Duffy A Gomez MR Cross S Leavitt JA Risk factors for developing multiple sclerosis after childhood optic neuritis Neurology 1997 Nov 49 5 1413 1418 10.1212/WNL.49.5.1413 9371931