Multiple sclerosis in children and adolescents
Katedra i Klinika Neurologii Wieku Rozwojowego, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu. Kierownik Kliniki: prof. UM dr hab. n. med. Barbara Steinborn
AKTUALN NEUROL 2009, 9 (4), p. 253-259

Multiple sclerosis (MS) is a rare disease of the central nervous system in the patients at developmental age. The onset of MS occurring in childhood constitutes less than 10% of the cases. The majority of data originating from the publications concerns the clinical course and laboratory investigations. At present not much is known about the sufficient competence in the histopathological findings, immunopathogenesis and genetic factors in the aforementioned age group. The suitable diagnostic criteria for the paediatric MS have not been defined yet, but many attempts have been made. At present McDonald’s criteria are obligatory, but they are less specific and sensitive for the children. To distinguish acute disseminated encephalomyelitis (ADEM) from the first attack of MS is still a challenging problem. In the differential diagnosis of paediatric MS it should be also taken into account: borreliosis, vasculitis, mitochondrial and metabolic disorders. Paediatric MS is associated with a more favourable course compared to adult MS, however, children can become disabled at a younger age. The relapsing-remitting course in paediatric MS concerns about 90% cases. The primary progressive course occurs rarely. The application of immunomodulatory therapies for children have been recommended, but still there is a lack of prospective investigations and long-term observations. Tolerability and efficacy of interferon β and glatiramer acetate appear to be similar to those observed at adults. In this paper we present the individualities of the childhood MS based on the literature available over the past decade. In particular, the authors present the symptoms, diagnostic and therapeutic difficulties of paediatric MS.

Keywords: multiple sclerosis, developmental age, McDonald criteria, acute disseminated encephalomyelitis, disease modifying therapy