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-9-22 10.15844/pedneurbriefs-9-3-10 Demyelinating Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Characteristics of Childhood 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 03 1995 01 06 2016 9 3 22 23 Copyright: © 1995 The Author(s) 1995 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. Pediatric multiple sclerosis report of 14 cases

The clinical manfestations of multiple sclerosis (MS) in 14 children are reported from the Universidade de Sao Paulo, Brazil.

 Multiple Sclerosis Bladder Dysfunction Minor Motor Impairment

The clinical manfestations of multiple sclerosis (MS) in 14 children are reported from the Universidade de Sao Paulo, Brazil. Age at onset ranged from 2 to 15 years. Initial symptoms varied from minor motor impairment, visual disturbances, bladder dysfunction and paresthesias, to a diffuse encephalopathy, with impaired consciousness. All had a relapsing-remitting course, and one died 6 months after onset with disseminated demyelinating lesions. CT showed demyelination in 6 of 9 patients. MRI showed white matter lesions in the brainstem or cerebral hemispheres in 5 of 6 patients. CSF pleocytosis occurred in 8 of 23 attacks, and g-globulin levels were increased in 7. Visual evoked potentials (VEP) were abnormal in 7 of 8 patients; BAEP in 4 of 8: and SEP in 4 of 8. The importance of paraclinical examinations in diagnosis is emphasized. [1]

COMMENT. The 14 cases were seen in a period of 12 years. Four presented before 5 years of age, and the youngest was 2 years.

According to a report from the George-August University, Gottingen, Germany, published in the review International MS Journal (Hanefeld FA. Int. MSJ 1995;1:90-97), 24 cases with MS onset before age 5 years have been published since 1969. In 20 of 39 new patients studied over a 5-year period in Gottingen, the onset was before 10 years. The onset or relapse was preceded by a nonspecific infection, usually an URI, in >50%. Of 8 presenting with optic neuritis, 4 developed MS within 2 years. CSF maximal cell count was 900/ml, and protein was increased >100 mg%. Oligoclonal bands were absent in one third. VEPs were more frequently abnormal than BAEP and SEP. MRI sometimes showed new lesions without accompanying symptoms or relapse, and remissions were not always reflected in less MRI changes. Patients with juvenile onset (>10 years) followed a more severe, frequently relapsing, course than those with onset before puberty.

 Guilhoto LM Osório CA Machado LR de Castro CP Manreza ML Callegaro D Pediatric multiple sclerosis report of 14 cases Brain Dev 1995 Jan-Feb 17 1 9 12 7762771 10.1016/0387-7604(94)00091-B