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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Bibliographic Details
Published in:Nature reviews. Neurology Vol. 5; no. 11; pp. 621 - 631
Main Authors: Yeh, E. Ann, Chitnis, Tanuja, Krupp, Lauren, Ness, Jayne, Chabas, Dorothée, Kuntz, Nancy, Waubant, Emmanuelle
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01.11.2009
Nature Publishing Group
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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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ISSN:1759-4758
1759-4766
1759-4766
DOI:10.1038/nrneurol.2009.158