Clinical, neurodiagnostic, and MR findings in children with spinal and brain stem multiple sclerosis.
OBJECTIVE
To describe the clinical, neurodiagnostic, and MR findings in seven children with brain stem and spinal multiple sclerosis.


METHODS
Spinal or brain stem multiple sclerosis was diagnosed in seven children between 1986 and 1992. All patients had neurologic and MR examinations as well as neurodiagnostic testing, including spinal fluid analysis and brain stem and auditory evoked potentials.


RESULTS
Three children had clinical findings and masslike lesions in the brain stem (two) or spinal cord (one) suggestive of neoplasm, which prompted biopsy (two) or radiation therapy (one). Five of six patients with spinal involvement had cord swelling with increased signal on T2-weighted images over at least three cord segments, and two children had essentially holocord involvement. Three children had normal cranial MR at presentation.


CONCLUSIONS
Multiple sclerosis involvement of the brain stem and spinal cord may be associated with extensive swelling and MR signal changes suggestive of neoplasm without typical cerebral white matter abnormalities. Serial clinical and neuroimaging examinations may be necessary to make a definitive diagnosis of multiple sclerosis in children.
Glasier
C M
CM
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock.
Robbins
M B
MB
Davis
P C
PC
Ceballos
E
E
Bates
S R
SR
D000293:Adolescent; D001284:Atrophy; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology; D001933:Brain Stem / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis / Q000473:pathology; D005072:Evoked Potentials, Auditory / Q000502:physiology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology* / Q000532:radiotherapy; D013116:Spinal Cord / Q000473:pathology* / Q000503:physiopathology; D013122:Spinal Diseases / Q000175:diagnosis / Q000473:pathology