Last modified: 2018-09-09
Abstract
Introduction
Although the frequency of pediatric-onset multiple sclerosis (POMS) has increased in recent decades, it is still highly uncommon, which creates a need for the involvement of more registries from various clinical centers.
Objective
To characterize the demographic, clinical, and paraclinical features of patients with POMS.
Subjects and methods
A retrospective multicenter review study was undertaken on 334 Egyptian patients with demyelinating events which started before the age of 18 years who attended one of six tertiary referral centers.
Results
Multiple sclerosis was diagnosed in 224 patients, 59 (26.3%) patients had disease onset before the age of 12 years; “early-onset pediatric multiple sclerosis (EOPMS)”. The mean age of disease onset was (14.13±2.49 years), with a female:male ratio of 1.73:1, none of the enrolled patients had a primary progressive course (PPMS), whereas 13 patients (5.8%) had a secondary progressive form. Approximately two-thirds of the patients had monofocal disease onset, and less than 10% presented with encephalopathy; most of them had EOPMS. Motor weakness was the presenting symptom in half of the patients, whereas cerebellar presentation was detected in 37.91%, mainly in EOPMS. Initial brain magnetic resonance images were positive in all patients, with detected atypical lesions in 31.03%, enhanced lesions in 38.18%, black holes in 13.98%, and infratentorial in 37.41%.
Conclusion
The results from this registry – one of the largest for POMS worldwide to date – are comparable to other registries. Clinical and paraclinical features of POMS are different from that of adult onset MS.