Emerging concepts in pediatric-onset multiple sclerosis and related disorders.
OBJECTIVE
Pediatric-onset multiple sclerosis (MS) is increasingly recognized. Conversely, MS diagnosis in the pediatric population continues to be challenging, particularly in the youngest group of patients. An interesting amount of data has been recently published concerning immunopathogenesis, environmental factors, diagnosis, and treatment of MS in pediatric patients.


RESULTS
Recent studies have demonstrated that brain MRI criteria may distinguish MS from acute disseminated encephalomyelitis, and from nondemyelinating disorders in children. The presence of native myelin oligodendrocyte glycoprotein antibodies strongly correlates with a particular pediatric MS phenotype. Vitamin D, Epstein-Barr virus infection, and cigarette smoke are risk factors likely to act at specific stages during life. Diffuse tissue damage was confirmed in normal-appearing white matter at early stages of disease in children with MS, pointing to the need for early treatment interventions. The cognitive involvement of MS in children is progressive.


CONCLUSIONS
Pediatric-onset MS needs a prompt identification and early treatment. Further multinational research studies are still necessary to advance on genetic, immunologic, and imaging features on the initial and ongoing aspects of this disorder in the pediatric population.
Tenembaum
Silvia N
SN
Pediatric MS Clinic and Related Disorders, Department of Neurology, National Pediatric Hospital Dr J. P. Garrahan, Buenos Aires, Argentina. silviatenembaum@hotmail.com
D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D004777:Environment; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology