Functional relapses in pediatric multiple sclerosis.
Multiple sclerosis in children is characterized by more frequent relapses than in adult patients. Diagnosing and treating youth with multiple sclerosis present a number of challenges including differentiating organic relapses from functional symptoms. However, there is no literature describing coexistence of functionality in pediatric multiple sclerosis. Here, we report 2 cases in which inconsistency between clinical history, physical examination, imaging, and atypical disease progression led to suspicion of functional relapses. The purpose of this study is to raise awareness of functional relapses, as prompt recognition can prevent overtreatment and iatrogenic risks in children and adolescents with multiple sclerosis. Underlying psychiatric issues also need to be addressed.
Partners Pediatric Multiple Sclerosis Center, Department of Child Neurology Massachusetts General Hospital, Boston, MA, USA.
Cristina
C
Fernández Carbonell
Partners Pediatric Multiple Sclerosis Center, Department of Child Neurology Massachusetts General Hospital, Boston, MA, USA.
Leslie
L
Benson
Partners Pediatric Multiple Sclerosis Center, Department of Child Neurology Massachusetts General Hospital, Boston, MA, USA Department of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
David
D
Rintell
Department of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Jefferson
J
Prince
Partners Pediatric Multiple Sclerosis Center, Department of Child Neurology Massachusetts General Hospital, Boston, MA, USA tchitnis@partners.org.
Tanuja
T
Chitnis
D000293:Adolescent; D005260:Female; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000503:physiopathology*; D010372:Pediatrics; D012008:Recurrence
Pediatric multiple sclerosis; children and adolescents; functional relapses