Pediatric multiple sclerosis
Despite its relative rarity, pediatric multiple sclerosis (MS) is an important entity, as it provides unique insights into disease processes related to MS. Clinical, MRI and laboratory data suggest differences in the immune response and CNS environment between adults and children with MS. Yeh et al...
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| Published in: | Nature reviews. Neurology Vol. 5; no. 11; pp. 621 - 631 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
Nature Publishing Group UK
01.11.2009
Nature Publishing Group |
| Subjects: | |
| ISSN: | 1759-4758, 1759-4766, 1759-4766 |
| Online Access: | Get full text |
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| Summary: | Despite its relative rarity, pediatric multiple sclerosis (MS) is an important entity, as it provides unique insights into disease processes related to MS. Clinical, MRI and laboratory data suggest differences in the immune response and CNS environment between adults and children with MS. Yeh
et al
. provide a comprehensive overview of the pediatric MS field, including epidemiology, disease mechanisms, diagnosis and treatment.
Pediatric multiple sclerosis (MS) accounts for up to 5% of all MS cases. Work conducted over the past 5 years has provided new information about the treatment, pathogenesis, demographics, and natural history of this disorder. Genetic and environmental factors seem to exert critical influences on its development. Clinical, MRI and laboratory data from prepubertal and postpubertal children suggest differences between the immune response and/or CNS environment in younger compared with older children and adults with MS. Randomized, controlled treatment trials for pediatric MS have not yet been performed, but therapies used in adult MS have been evaluated in this population, and their use seems to be safe. This article provides a comprehensive review of current knowledge regarding pediatric MS, highlighting new advances in the field.
Key Points
Pediatric multiple sclerosis (MS) represents ∼3–4% of all cases of MS
In North America, greater diversity in ethnicity, race and ancestry is observed among individuals with pediatric MS than among adults with MS, possibly reflecting changing demographic trends
Studies have suggested environmental influences on pediatric MS susceptibility, including Epstein–Barr virus and exposure to cigarette smoke
Acute disseminating encephalomyelitis must be differentiated from MS and is seen more commonly in children than in adults
New MRI criteria will, hopefully, help to discriminate pediatric MS from acute disseminated encephalomyelitis
Currently available first-line therapies for adults with MS seem to be safe and well tolerated in pediatric MS |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 |
| ISSN: | 1759-4758 1759-4766 1759-4766 |
| DOI: | 10.1038/nrneurol.2009.158 |