A Clinical Study of Childhood Onset Multiple Sclerosis

Jhang, Won Kyung; You, Su Jeong; Kim, Deok Soo; Ko, Tae Sung

Abstract

PURPOSE: It is well known that multiple sclerosis(MS) is a demyelinating disease of the central nervous system that mostly starts in the second to third decades. In the present study, we reviewed our own observations of the clinical and paraclinical features of the MS patients whose symptoms started before 16 years of age.
METHODS
The study concerns the patients admitted to the pediatric department of Asan Medical Center for a period of 5 years(from January 1996 to December 2002). We retrospectively reviewed 13 patients who were diagnosed as early onset multiple sclerosis by Rose criteria on the basis of clinical symptoms and brain MRI findings.
RESULTS
Of these 13 patients, 5 patients(38.5%) fulfilled the criteria of clinically definite MS and 7 patients(53.8%) fulfilled the criteria of clinically probable MS. The average age at onset was 10.3 years old. In six patients, the disease onset was polysymptomatic. Diplopia was the most common initial manifestation and occurred in 8 patients (61.5%). Others presented with urinary incontinence, ataxia, seizures and so on. All the patients had typical T2-hyperintensive lesions on brain MRI and brainstem lesions were found in 5 patients(38.5%). All the patients responsed to intravenous methylprednisolone very well. No long-term neurologic sequelae were observed.
CONCLUSION
Although childhood onset MS is rarely seen and may begin with unusual features, it dose not significantly differ from that typically seen in adults in terms of major clinical manifestations and clinical course of the disease. It is also suggested that MRI is a sensitive and effective tool for the diagnosis of MS.