| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Division of Pediatric Neurology, Department of Pediatrics (Drs. Ruggieri, Polizzi, and Pavone), University of Catania; IBFSNC (Dr. Ruggieri), CNR, Catania; Neuroimmunology Unit, Department of Neuroscience (Dr. Grimaldi), San Raffaele Scientific Institute, Milan, Italy; and the Departments of Clinical Genetics and Pediatrics (Dr. Ruggieri) and Department of Clinical Neurology, Neuroscience Group, IMM (Dr. Polizzi), John Radcliffe Hospital, Oxford, UK.
Address correspondence and reprint requests to Dr. Martino Ruggieri, Division of Pediatric Neurology, Department of Pediatrics, University of Catania, Catania 95125, Italy.
OBJECTIVES: To characterize MS patients with the earliest onset of disease. Background: MS—primarily a disease of young adulthood—begins in childhood in 3 to 5% of cases. However, onset before 10 years of age is considered exceptional. Accordingly, inclusion age at onset is generally between 10 and 59 years. Methods: Information was obtained on patients with MS treated at our institution (n = 6) or from reports in Medline or bibliographies. Onset of disease was before 6 years of age, for a total of 49 patients (29 girls, 20 boys). Results: All patients had clinically defined MS according to Poser’s criteria; 22 were also laboratory supported. The female/male ratio (1.4) was lower than that usually recorded for adult onset MS (2.0) and that of MS with onset between 6 and 15 years (2.2 to 3.0). The group of patients (n = 5) with onset before 24 months of age showed the lowest ratio (0.6) and carried the most unfavorable prognosis. Among initial symptoms, ataxia was preponderant (61%). Optic nerve involvement became more frequent with age. Generalized or partial seizures occurred in 22% of cases. First inter-attack interval was less than 1 year in 63% of the cases. The yearly relapse rate ranged from 1.1 at disease onset to 0.2 after 9 years from disease onset. At follow-up (mean length 6.8 years), the disease was relapsing-remitting in 84% patients and the grade of recovery was complete in 64%. Conclusions: Definite MS can be consistently diagnosed by current criteria for adult onset MS in patients with the earliest onset of disease who show peculiar clinical features and natural history. These findings may suggest a reconsideration of current lower limits for MS diagnostic criteria.
This article has been cited by other articles:
|
|
 |
|
  A Pichiecchio, E Tavazzi, G Maccabelli, C. Precupanu, A Romani, L Roccatagliata, G Luccichenti, R Bergamaschi, and S Bastianello What insights have new imaging techniques given into aggressive forms of MS - different forms of MS or different from MS? Multiple Sclerosis, March 1, 2009; 15(3): 285 - 293. [Abstract] [PDF]
|
|
|
|
 |
|
 D. Chabas, T. Castillo-Trivino, E. M. Mowry, J. B. Strober, O. A. Glenn, and E. Waubant Vanishing MS T2-bright lesions before puberty: A distinct MRI phenotype? Neurology, September 30, 2008; 71(14): 1090 - 1093. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Renoux, S. Vukusic, Y. Mikaeloff, G. Edan, M. Clanet, B. Dubois, M. Debouverie, B. Brochet, C. Lebrun-Frenay, J. Pelletier, et al. Natural History of Multiple Sclerosis with Childhood Onset N. Engl. J. Med., June 21, 2007; 356(25): 2603 - 2613. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Hanefeld Pediatric multiple sclerosis: A short history of a long story Neurology, April 17, 2007; 68(16_suppl_2): S3 - S6. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Ness, D. Chabas, A. D. Sadovnick, D. Pohl, B. Banwell, B. Weinstock-Guttman, and for the International Pediatric MS Study Group Clinical features of children and adolescents with multiple sclerosis Neurology, April 17, 2007; 68(16_suppl_2): S37 - S45. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Correale and S. N Tenembaum Myelin basic protein and myelin oligodendrocyte glycoprotein T-cell repertoire in childhood and juvenile multiple sclerosis Multiple Sclerosis, August 1, 2006; 12(4): 412 - 420. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Song, Z. Guan, I. E. Gienapp, T. Shawler, J. Benson, and C. C. Whitacre The Thymus Plays a Role in Oral Tolerance in Experimental Autoimmune Encephalomyelitis J. Immunol., August 1, 2006; 177(3): 1500 - 1509. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Marrie, G. Cutter, T. Tyry, O. Hadjimichael, D. Campagnolo, and T. Vollmer Changes in the ascertainment of multiple sclerosis Neurology, October 11, 2005; 65(7): 1066 - 1070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Pohl, K. Rostasy, H. Reiber, and F. Hanefeld CSF characteristics in early-onset multiple sclerosis Neurology, November 23, 2004; 63(10): 1966 - 1967. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Mikaeloff, C. Adamsbaum, B. Husson, L. Vallee, G. Ponsot, C. Confavreux, M. Tardieu, S. Suissa, and the KIDMUS Study Group on Radiology MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood Brain, September 1, 2004; 127(9): 1942 - 1947. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L J Etheridge, D W Beverley, C Ferrie, and E McManus The use of interferon beta in relapsing-remitting multiple sclerosis Arch. Dis. Child., August 1, 2004; 89(8): 789 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kurul, H. Cakmakci, E. Dirik, and A. Kovanlikaya Schilder's Disease: Case Study With Serial Neuroimaging J Child Neurol, January 1, 2003; 18(1): 58 - 61. [Abstract] [PDF]
|
|
|
|
|
|
I. L. Simone, D. Carrara, C. Tortorella, M. Liguori, V. Lepore, F. Pellegrini, A. Bellacosa, A. Ceccarelli, I. Pavone, and P. Livrea Course and prognosis in early-onset MS: Comparison with adult-onset forms Neurology, December 24, 2002; 59(12): 1922 - 1928. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Boiko, G. Vorobeychik, D. Paty, V. Devonshire, D. Sadovnick, and the UBC MS Clinic Neurologists Early onset multiple sclerosis: A longitudinal study Neurology, October 8, 2002; 59(7): 1006 - 1010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. N. K. Murthy, H. S. Faden, M. E. Cohen, and R. Bakshi Acute Disseminated Encephalomyelitis in Children Pediatrics, August 1, 2002; 110(2): e21 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Haliloglu, B. Anlar, S. Aysun, M. Topcu, H. Topaloglu, G. Turanli, and D. Yalnizoglu Gender Prevalence in Childhood Multiple Sclerosis and Myasthenia Gravis J Child Neurol, May 1, 2002; 17(5): 390 - 392. [Abstract] [PDF]
|
|
|
|
|
|
A Ghezzi, C Pozzilli, M Liguori, M G Marrosu, N Milani, C Milanese, I Simone, and M Zaffaroni Prospective study of multiple sclerosis with early onset Multiple Sclerosis, April 1, 2002; 8(2): 115 - 118. [Abstract] [PDF]
|
|
|
|
|
|
J.L. Hynson, A.J. Kornberg, L.T. Coleman, L. Shield, A.S. Harvey, and M.J. Kean Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children Neurology, May 22, 2001; 56(10): 1308 - 1312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Belopitova, V. Guergueltcheva, and V. Bojinova Definite and Suspected Multiple Sclerosis in Children: Long-Term Follow-up and Magnetic Resonance Imaging Findings J Child Neurol, May 1, 2001; 16(5): 317 - 324. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
