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Multiple Sclerosis in Childhood: Clinical and Radiological Features

Department of Neurology Royal Children's Hospital, Melbourne, Australia

Lee Coleman, FRANZCR, MBChB, BSc

Department of Radiology Royal Children's Hospital, Melbourne, Australia, University of Melbourne, Parkville, Australia

Andrew J. Kornberg, MBBS, DipTA ATAA, FRACP

Department of Neurology Royal Children's Hospital, Melbourne, Australia, University of Melbourne, Parkville, Australia, andrew.kornberg{at}rch.org.au

We analyzed the medical records and cerebral imaging of 30 children with early onset multiple sclerosis to compare the clinical and neuro-radiological features with acute demyelinating encephalomyelitis and adult multiple sclerosis. The female:male ratio was 1.3 before the age of 12 years and increased to 4.3 after age 12 years. Optic neuritis and pyramidal dysfunction were the most common presenting clinical features. The most common radiological features at first imaging were periventricular (77.2%), corpus callosal demyelination (63.6%), gadolinium enhancement (62.5%), and Dawson's fingers (40.9%). The median relapse rate per patient year was 1.2 ([IQR] 0.6-2.0). Seven patients reached a moderate Expanded-Disability-Status-Scale score of 3 and 3 patients were more severely affected (score of 6). Expanded-Disability-Status-Scale score increased by 0.7 for every relapse. Ten patients were commenced on immunomodulatory therapy (Interferon beta 1a, n = 9; Interferon beta 1b, n = 3; or Glatiramer acetate, n = 1), the majority of who had minimal side effects and a reduction in relapse rate.

Key Words: acute disseminated encephalomyelitis • ADEM • early onset multiple sclerosis • MS • interferon • glatiramer • outcome • MRI

This version was published on January 1, 2009

Journal of Child Neurology, Vol. 24, No. 1, 56-62 (2009)
DOI: 10.1177/0883073808321042


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