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Clinical presentation of pediatric multiple sclerosis before puberty
Author(s) -
Huppke B.,
Ellenberger D.,
Rosewich H.,
Friede T.,
Gärtner J.,
Huppke P.
Publication year - 2014
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12327
Subject(s) - medicine , multiple sclerosis , pediatrics , disease , presentation (obstetrics) , optic neuritis , surgery , psychiatry
Background and purpose Multiple sclerosis (MS) onset before puberty is extremely rare and establishment of diagnosis is often difficult due to atypical presentation. The study aims to identify the typical presentation of MS in this age group. Methods Pediatric MS patients were identified from the database of the C enter for M ultiple S clerosis in C hildhood and A dolescence at the U niversity M edical C enter G öttingen, G ermany. Inclusion criteria were a relapsing−remitting initial disease course and minimum disease duration of 4 years. Results Forty‐seven pre‐pubertal (<11 years) and 41 post‐pubertal (14–16 years) MS patients were compared. Before puberty an even gender ratio was found. The pre‐pubertal patients were more likely to have a polysymptomatic severe first attack with motor and brainstem involvement, sphincter dysfunction, cognitive disturbances and milder residual neurological sequelae after the first episode whilst the post‐pubertal patients predominantly presented with optic neuritis and sensory symptoms. The initial symptom pattern prevailed over the first 2 years of disease. Presentation of pre‐pubertal boys and girls did not differ significantly. Conclusions To facilitate early diagnosis it is important to recognize that pre‐pubertal MS presents with a specific pattern of symptoms that is maintained over the first two disease years.