تقرير
أعرض في EDS

Multiple sclerosis under the age of ten: the challenge of a rare diagnosis in a special population - a case series.

التفاصيل البيبلوغرافية
العنوان: Multiple sclerosis under the age of ten: the challenge of a rare diagnosis in a special population - a case series.
المؤلفون: Carvalho IV; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.; Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Dos Santos CS; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Amaral J; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Ribeiro JA; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Pereira C; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Pais RP; Medical Image Department - Neuroradiology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Palavra F; Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.; Laboratory of Pharmacology and Experimental Therapeutics, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Clinical Academic Center of Coimbra, Coimbra, Portugal.
المصدر: Frontiers in neuroscience [Front Neurosci] 2023 Dec 20; Vol. 17, pp. 1297171. Date of Electronic Publication: 2023 Dec 20 (Print Publication: 2023).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101478481 Publication Model: eCollection Cited Medium: Print ISSN: 1662-4548 (Print) Linking ISSN: 1662453X NLM ISO Abbreviation: Front Neurosci Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Lausanne : Frontiers Research Foundation
مستخلص: Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system which, when it begins before the age of 18, is defined as paediatric MS. Most common clinical presentations include long tract involvement, brainstem/cerebellum syndromes, optic neuritis and acute disseminated encephalomyelitis. Paediatric-onset MS typically has a more inflammatory-active course and a higher lesion burden in imaging studies, but an extensive post-relapse recovery, with a slower long-term disability progression. The first demyelinating clinical attack occurs before 10 years old in less than 1% of patients, and, in this special population, the condition has particularities in clinical presentation, differential diagnosis, diagnostic assessment, current treatment options and outcome.
Clinical Cases: We present the cases of four Caucasian children (2 girls) diagnosed with relapsing-remitting MS before the age of ten, with a mean age at the time of the first relapse of 7.4 ± 2.4 years. Clinical presentation included optic neuritis, myelitis, brainstem syndrome, and acute disseminated encephalomyelitis. Baseline MRI identified several lesions, frequently large and ill-defined. Two patients were included in clinical trials and two patients remain in clinical and imaging surveillance.
Conclusion: Diagnosis of MS before the age of 10 years is rare, but it has significant long-term physical and cognitive consequences, as well as a substantial impact on the current and future quality of life of the child and family. Early and correct diagnosis is essential. Prospective, randomized, large cohort studies are needed to assess the efficacy and safety of disease-modifying treatments in children under the age of ten.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Carvalho, dos Santos, Amaral, Ribeiro, Pereira, Pais and Palavra.)
References: Dev Med Child Neurol. 1995 Aug;37(8):667-72. (PMID: 7672463)
Clin Immunol. 2022 Apr;237:108947. (PMID: 35123059)
Children (Basel). 2021 Dec 25;9(1):. (PMID: 35053636)
Arch Neurol. 2009 Jan;66(1):54-9. (PMID: 19139299)
Neurol Sci. 2004 Nov;25 Suppl 4:S346-9. (PMID: 15727231)
Neurology. 2021 Nov 16;97(20):e2007-e2019. (PMID: 34607928)
Neurology. 2005 Mar 8;64(5):891-4. (PMID: 15753431)
Neurology. 2018 Nov 6;91(19):e1778-e1787. (PMID: 30333163)
Neuropsychol Rev. 2023 Jun;33(2):459-473. (PMID: 35802297)
Continuum (Minneap Minn). 2022 Aug 1;28(4):1104-1130. (PMID: 35938659)
Brain. 2007 Oct;130(Pt 10):2589-95. (PMID: 17827175)
Lancet Neurol. 2011 May;10(5):436-45. (PMID: 21459044)
Pediatr Neurol. 1989 Sep-Oct;5(5):317-9. (PMID: 2803391)
Childs Nerv Syst. 1990 Jun;6(4):236-8. (PMID: 2383880)
N Engl J Med. 2007 Jun 21;356(25):2603-13. (PMID: 17582070)
Biomedicines. 2020 Mar 28;8(4):. (PMID: 32231060)
Neurology. 1999 Aug 11;53(3):478-84. (PMID: 10449107)
BMC Neurol. 2018 Mar 9;18(1):27. (PMID: 29523094)
Lancet Neurol. 2018 Feb;17(2):162-173. (PMID: 29275977)
Mult Scler Relat Disord. 2020 Feb;38:101874. (PMID: 31805467)
Rev Neurol (Paris). 2020 Jan - Feb;176(1-2):30-36. (PMID: 31088692)
Case Rep Pediatr. 2012;2012:684064. (PMID: 22844627)
Neurology. 1983 Nov;33(11):1444-52. (PMID: 6685237)
Pediatr Neurol. 2015 Oct;53(4):287-92. (PMID: 26233264)
Neurol Sci. 2004 Nov;25 Suppl 4:S326-35. (PMID: 15727227)
J Pediatr. 2004 Feb;144(2):246-52. (PMID: 14760270)
Neuropediatrics. 2018 Feb;49(1):51-58. (PMID: 29183093)
Neurodegener Dis Manag. 2016;6(1):31-6. (PMID: 26782315)
Adv Pediatr. 2019 Aug;66:209-229. (PMID: 31230695)
Eur J Neurol. 2014 Mar;21(3):441-6. (PMID: 24330201)
Neurology. 2002 Oct 8;59(7):1006-10. (PMID: 12370453)
Neurol Neurochir Pol. 2020;54(6):508-517. (PMID: 32940341)
Neurology. 2014 Oct 14;83(16):1432-8. (PMID: 25217060)
Pediatrics. 2006 Sep;118(3):1133-9. (PMID: 16951008)
Nat Rev Microbiol. 2023 Jan;21(1):51-64. (PMID: 35931816)
Lancet Child Adolesc Health. 2018 Mar;2(3):191-204. (PMID: 30169254)
Clin Neurol Neurosurg. 2008 Nov;110(9):897-904. (PMID: 18534742)
Lancet Neurol. 2021 Feb;20(2):136-149. (PMID: 33484648)
Mult Scler. 2013 Sep;19(10):1261-7. (PMID: 23572237)
Semin Neurol. 2020 Apr;40(2):192-200. (PMID: 32294785)
Ann Neurol. 2010 May;67(5):618-24. (PMID: 20437559)
CNS Drugs. 2022 Jan;36(1):45-59. (PMID: 34940954)
Front Neurol. 2021 May 17;12:676095. (PMID: 34079516)
Neurology. 2021 Nov 16;97(20):929-930. (PMID: 34607920)
Cent Nerv Syst Agents Med Chem. 2018 Jan 26;18(1):16-20. (PMID: 26654228)
Dev Med Child Neurol. 2019 Sep;61(9):1039-1049. (PMID: 30932181)
J Neurol Neurosurg Psychiatry. 2013 Feb;84(2):141-7. (PMID: 23154123)
J Child Neurol. 1987 Oct;2(4):252-6. (PMID: 2821095)
فهرسة مساهمة: Keywords: children; diagnosis; multiple sclerosis; paediatric; treatment
تواريخ الأحداث: Date Created: 20240104 Latest Revision: 20240105
رمز التحديث: 20240105
مُعرف محوري في PubMed: PMC10761493
DOI: 10.3389/fnins.2023.1297171
PMID: 38174051
قاعدة البيانات: MEDLINE
الوصف
تدمد:1662-4548
DOI:10.3389/fnins.2023.1297171