Pediatric multiple sclerosis

Multiple Sclerosis (MS), a chronic inflammatory autoimmune disease of the central nervous system (CNS), is most commonly diagnosed in (young) adults, but can alsoaffect children. Pediatric MS, also referred to as pediatric-onset MS (POMS), earlyonset MS or juvenile MS, is generally defined as MS with an onset before the age of16 years (sometimes before the age of 18 years).Between 3 and 10% of patients with MS present under 16 years of age and < 1% less than 10 years of age. was 13.7years. The mean age at onset Pediatric MS has distinctive features and the disease course is different than adults.Children are less likely to develop primary or secondaryprogressive MS.98% of pediatric MS patients present with a relapsing–remitting course, compared with 84%of adult patients. Relapses appear to be more frequent in patients with POMS compared with adult onset MS .The clinical phenotype differs from that of adult patients.In that pediatric MS patients generally experience a more aggressive disease onset with a polyfocal presentation at disease onset and a higher relapse rate early in the disease course. „ Overall, children tend to have a more favorable outcome after a first clinical event. „ Secondary progression and disability milestones at ages approximately 10 years younger than patients with adult-onset disease, despite a slower development of irreversible disability.The 50% risks to reach expanded disability status Scale 3 and 6 were 23 and 28 years after MS onset, compared to 10 and 18 years in the comparator group. „ In pediatric MS time from onset to confirmed disability may be relatively long, but disability milestone is reached at an earlier age. „ MS is associated with significant cognitive impairment in childhood (31%). „ Children with initial clinically isolated syndrome(CIS) are more likely to develop MS than those with acute disseminated encephalomyelitis )ADEM) as initial diagnosis. „ Conversion from CIS to MS occurred in 38.8% of children and from ADEM to MS in 8.5% of children.„ The current first-line treatment of MS in children consists of either interferon beta or glatiramer acetate.