Multiple Sclerosis in Children: A Review of Clinical and Paraclinical Features in 26 Cases

Objective

Multiple sclerosis (MS) is an inflammatory demyelinating disease of central nervous system (CNS) that is increasingly being recognized as a disease affecting children. However, the clinical features of childhood MS at onset have been rarely reported from Asia.

Materials & Methods

This report presents a retrospective chart review of 26 patients with MS (20 females and 6 males), with an onset age of MS of less than 16 years, in the south of Iran between March 2001and November 2007; it documents researchers' experiences

Results

Female/male ratio was 3:1. Mean age in females was higher than males (13 vs.12.16).The disease was highly variable in onset presentation; the most common initial symptoms were limb weakness, disequilibrium, and diplopia. Three patients had a positive family history of MS in their first degree relatives. VEP was abnormal in 9 of 19(47%). MRI demonstrated multiple plaques in the brain in 24(92%) cases. Relapse remitting MS was a dominant pattern noticed in 23(88%) cases.

Conclusion

MS, in childhood, is not as rare as commonly believed; although its diagnosis is essentially a clinical one, paraclinical investigations are of great value in the identification of demyelinating disorders in childhood. The disease, as it occurs in children, does not appear to differ clinically from the disease as observed in adults. If pediatricians should confront a child showing evidence of scattered

neurological deficits that remit, particularly weakness, disturbance of vision and co-ordination, they need to consider the possibility of MS.