Introduction: The recognition of multiple sclerosis (MS)  in children and adolescents increases recently, however, initial brain MRI  may not be sufficient to establish the proper diagnosis in many children. According to McDonald’s criteria, spinal cord lesions may be important for the  diagnosis. The purpose of our study was to determine the prevalence of spinal cord lesions revealed by MRI in children and adolescents with clinically definite MS.

Material and methods: Initial spinal cord MRI in 57 children and adolescents (37 girls and 20 boys, aged from 7 to 18 years, mean 14.1 years) with clinically definite MS were reviewed. All patients had typical MS lesions revealed on brain MRI and none met the diagnostic criteria for neuromyelitis optica (NMO). Total lesion count, lesion location, and gadolinium enhancement, as well as  clinical  symptoms  were analyzed.

Results:  Spinal cord lesions were identified in 35 (61.4%) patients. Contrast enhancement was present in 37.1% of them. In 36 patients, the clinical symptoms of spinal cord involvement were revealed by neurological examinations. There was no correlation between clinical symptoms of spinal cord involvement and MRI.

Conclusions: The prevalence of spinal cord lesions in children and adolescents with MS is high. Therefore, spinal cord MRI with contrast should be performed in every child suspected as having MS, irrespective of clinical  presentation.