Ozgul Ekmekci

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/63919

#### **Abstract**

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disorder of the central nervous system. Although pediatric and adult-onset MS have similar neurolog‐ ic symptoms, there are some differences from adults in radiologic findings, cognitive features, clinical course, and diagnostic criteria of pediatric MS. Diagnostic criteria and radiologic features of pediatric MS have been defined in recent years. There are no large, randomized, controlled therapeutic trials in pediatric MS. In this chapter, clinical characteristics, diagnostic criteria, laboratory findings, differential diagnosis, and treatment of pediatric MS are summarized.

**Keywords:** multiple sclerosis, pediatric multiple sclerosis, childhood multiple sclero‐ sis, demyelinating disorders, demyelination

#### **1. Introduction**

Multiple sclerosis (MS) is an autoimmune chronic inflammatory disease of the central nerv‐ ous system; it is characterized by demyelination and axonal loss. MS primarily affects young adults. Recently, it has been increasingly recognized in children and adolescents. Approxi‐ mately 2–5% of all MS patients have onset before age 18 [1, 2]. Onset before 10 years of age occurs in less than 1% of all patients. There are some differences, including clinical presentation, magnetic resonance imaging (MRI) findings, and neuroimmunologic features, between pediatric and adult MS patients. The first attack can be acute disseminated encephalomyelitis, particularly in young children. Relapses are more frequent in pediatric MS patients than in adults, though improvement is better. Cognitive impairment including linguistic dysfunction and reduction in IQ scores also differs from adults. T2 lesion burden is higher in pediatric patients

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in MRI as compared to adult MS patients. These differences are more marked in prepuberal children [3]. The still developing central nervous and immune systems may be responsible for these differences. However, studies on pathogenesis and pathology of pediatric MS are limited.
