Neli Bizjak1, Damjan Osredkar1, Mirjana Perković Benedik1, Saša Šega Jazbec2. 1. Departments of Child, Adolescent and Developmental Neurology, University Children's Hospital, University Medical Centre Ljubljana, Slovenia. 2. Department of Neurology, University Medical Centre Ljubljana, Slovenia.
Abstract
BACKGROUND: Although multiple sclerosis usually affects young adults, paediatric-onset multiple sclerosis (pMS) is increasingly recognized in the past ten years. The aim of the present study was to evaluate the incidence of pMS in Slovenia and to characterize the clinical, laboratory and neuroradiological characteristics of pMS at the disease onset. METHODS: We performed a national retrospective descriptive study including all patients diagnosed with pMS between January 1992 and June 2017. We reviewed data of all patients younger than 18 years at the first demyelinating event. RESULTS: The estimated incidence of pMS was 0.66/100,000 children per year. We included 61 patients (77% were female) with a median age at diagnosis of 16.3 years. In 4 patients, onset of pMS was before the age of 12 years old (childhood-onset pMS). Relapsing-remitting multiple sclerosis was most prevalent, with only 2 patients presenting a primary progressive pMS. Polysymptomatic pMS was found at onset in 59% of patients and monosymptomatic in 41%. In the cerebrospinal fluid study, 88% of patients had positive oligoclonal bands. Brain magnetic resonance imaging studies showed a predominant supratentorial involvement (100% of patients). CONCLUSION: The clinical pattern of pMS in our cohort of patients was characterized by polysymptomatic presentation and predominantly sensory symptoms at onset, developing a relapsing-remitting pMS pattern. It is important to gather more information about the incidence of pMS and its initial presentation and clinical course to improve early recognition and appropriate initiation of immunomodulatory treatment.
BACKGROUND: Although multiple sclerosis usually affects young adults, paediatric-onset multiple sclerosis (pMS) is increasingly recognized in the past ten years. The aim of the present study was to evaluate the incidence of pMS in Slovenia and to characterize the clinical, laboratory and neuroradiological characteristics of pMS at the disease onset. METHODS: We performed a national retrospective descriptive study including all patients diagnosed with pMS between January 1992 and June 2017. We reviewed data of all patients younger than 18 years at the first demyelinating event. RESULTS: The estimated incidence of pMS was 0.66/100,000 children per year. We included 61 patients (77% were female) with a median age at diagnosis of 16.3 years. In 4 patients, onset of pMS was before the age of 12 years old (childhood-onset pMS). Relapsing-remitting multiple sclerosis was most prevalent, with only 2 patients presenting a primary progressive pMS. Polysymptomatic pMS was found at onset in 59% of patients and monosymptomatic in 41%. In the cerebrospinal fluid study, 88% of patients had positive oligoclonal bands. Brain magnetic resonance imaging studies showed a predominant supratentorial involvement (100% of patients). CONCLUSION: The clinical pattern of pMS in our cohort of patients was characterized by polysymptomatic presentation and predominantly sensory symptoms at onset, developing a relapsing-remitting pMS pattern. It is important to gather more information about the incidence of pMS and its initial presentation and clinical course to improve early recognition and appropriate initiation of immunomodulatory treatment.
Authors: Naila Makhani; Christine Lebrun; Aksel Siva; Sona Narula; Evangeline Wassmer; David Brassat; J Nicholas Brenton; Philippe Cabre; Clarisse Carra Dallière; Jérôme de Seze; Francoise Durand Dubief; Matilde Inglese; Megan Langille; Guillaume Mathey; Rinze F Neuteboom; Jean Pelletier; Daniela Pohl; Daniel S Reich; Juan Ignacio Rojas; Veronika Shabanova; Eugene D Shapiro; Robert T Stone; Silvia Tenembaum; Mar Tintoré; Ugur Uygunoglu; Wendy Vargas; Sunita Venkateswaren; Patrick Vermersch; Orhun Kantarci; Darin T Okuda; Daniel Pelletier Journal: Mult Scler J Exp Transl Clin Date: 2019-03-20
Authors: Niklas Frahm; Melanie Peters; Jörg Bätzing; David Ellenberger; Manas K Akmatov; Judith Haas; Paulus S Rommer; Alexander Stahmann; Uwe K Zettl; Jakob Holstiege Journal: Ther Adv Neurol Disord Date: 2021-10-06 Impact factor: 6.570