Pediatric multiple sclerosis

Diagnosing multiple sclerosis (MS) in a child is challenging because of the limited diagnostic criteria and their overlap with acute disseminated encephalomyelitis. Pediatric-onset MS patients are more likely to be male, have seizures, and have brainstem and cerebellar symptoms than adults, and are...

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Vydáno v:Current neurology and neuroscience reports Ročník 8; číslo 5; s. 434 - 441
Hlavní autoři: Chabas, Dorothee, Strober, Jonathan, Waubant, Emmanuelle
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York Current Science Inc 01.09.2008
Springer Nature B.V
Témata:
Adolescent
Age of Onset
Brain - pathology
Child
Diagnosis, Differential
Disease Progression
Encephalomyelitis, Acute Disseminated - diagnosis
Ethnic Groups - statistics & numerical data
Female
Humans
Magnetic Resonance Imaging
Male
Medical treatment
Medicine
Medicine & Public Health
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - drug therapy
Multiple Sclerosis - epidemiology
Multiple Sclerosis - pathology
Multiple Sclerosis - psychology
Multiple Sclerosis, Relapsing-Remitting - epidemiology
Neurology
Neuromyelitis Optica - diagnosis
Neurosciences
Phenotype
Quality of Life
Risk Factors
Multiple Sclerosis
Optic Neuritis
Clinically Isolate Syndrome
Neuromyelitis Optica
Multiple Sclerosis Patient
ISSN:1528-4042, 1534-6293, 1534-6293
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Popis
Shrnutí:Diagnosing multiple sclerosis (MS) in a child is challenging because of the limited diagnostic criteria and their overlap with acute disseminated encephalomyelitis. Pediatric-onset MS patients are more likely to be male, have seizures, and have brainstem and cerebellar symptoms than adults, and are less likely to have spinal cord symptoms than adults. They mostly experience a relapsing-remitting course. Their initial brain MRI shows more frequent involvement of the posterior fossa, less well-defined ovoid lesions, and more confluent lesions that decrease over time in patients with prepubertal onset, making early diagnosis even more difficult. Although disability progression is slower than in adults, pediatric onset MS leads to significant disability at a younger age and may be worse in non-white patients (up to 50% in North America). The rareness of pediatric-onset MS has precluded enrollment in clinical trials. Thus, children are receiving off-label adult therapies without clear evidence of their effectiveness and limited knowledge of their tolerability.
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ISSN:1528-4042
1534-6293
1534-6293
DOI:10.1007/s11910-008-0067-1