title: Paediatric multiple sclerosis and acute disseminated encephalomyelitis in Germany: results of a nationwide survey.
abstract: The aim of this study was to evaluate the incidence of paediatric multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM) in Germany. In a prospective nationwide survey carried out between 1997 and 1999, all registered new cases of paediatric MS and ADEM with an onset before the age of 16 years were evaluated using a standardised questionnaire. A total of 132 patients with suspected or definite MS and 28 patients with an assumed diagnosis of ADEM were reported. Among these, 82% of the MS patients were 10 years of age or older, as opposed to 18% in the ADEM-cohort. The female-to-male ratio was 1.2:1 in the MS-cohort and 0.8:1 in the ADEM-cohort. Manifestation was polysymptomatic in 67% of the MS patients compared to 86% of the ADEM patients. The most frequent primary symptoms in the MS-cohort were cerebellar (44%), sensory (39%) or visual (36%), followed by brainstem (30%), pyramidal (29%) and cerebromental (22%) complaints.
  
  
  CONCLUSIONS
  The incidence of paediatric MS in Germany is more than fourfold higher than that of paediatric ADEM; in addition, it shows a strikingly different age-distribution. With an estimated minimum of 50 new cases per year, the incidence of paediatric MS in Germany is much more frequent than previously believed.
authors.affiliation: Department of Paediatrics and Paediatric Neurology, Georg-August-University, Robert-Koch-Strasse 40, 37075, Göttingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pohl
authors.forename: Isabell
authors.initials: I
authors.lastname: Hennemuth
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Folker
authors.initials: F
authors.lastname: Hanefeld
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004673:Encephalomyelitis, Acute Disseminated / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology*; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires