title: Multiple sclerosis in children and adolescents. An important differential diagnosis of acute neurological disease.
abstract: OBJECTIVE
  Multiple sclerosis (MS) has traditionally been considered a disease of adults. However, in recent years, there have been numerous reports about the disease occurring in childhood and adolescence. The purpose of this article is to document Norwegian experience of this population based on clinical observations and neuroradiological findings.
  
  
  METHODS
  Children and adolescents diagnosed with MS at the Department of Child Neurology, Oslo University Hospital, between 1 January 2004 and 1 May 2012 were included. Gender, previous diseases, age, symptoms at first attack, spinal fluid findings and cerebral magnetic resonance tomography (MRI) findings were recorded. The course of the disease, treatment and sequelae was noted.
  
  
  RESULTS
  The study includes 18 patients who received MS diagnosis. Median age at onset was 10 years and six months. The presenting symptoms and MRI findings varied. Almost all patients were treated with steroids in the acute phase and later with interferon-beta. Some patients were treated with natalizumab when there was lack of efficiency of interferon-beta. Seven patients developed permanent, moderate sequelae in terms of motor, sensory, or cerebellar symptoms. Nine patients had cognitive difficulties and 11 specified increased fatigability.
  
  
  CONCLUSIONS
  MS in children and adolescents is a disease with varying acute neurological symptoms and findings. The patients were treated with the same medicines as adults with MS and tolerated it well. We found that cognitive sequelae and fatigue were common also in this young age group.
authors.affiliation: Department of Child Neurology, Women and Children's Division, Oslo University Hospital, Norway. Electronic address: ingsan@online.no.
authors.forename: Inger
authors.initials: I
authors.lastname: Sandvig
authors.affiliation: Department of Child Neurology, Women and Children's Division, Oslo University Hospital, Norway.
authors.forename: Jon
authors.initials: J
authors.lastname: Barlinn
authors.affiliation: Department of Radiology, Division of Diagnostics and Intervention, Oslo University Hospital, Norway.
authors.forename: Bård
authors.initials: B
authors.lastname: Nedregaard
authors.affiliation: Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gotenburg University, Sweden.
authors.forename: Ola H
authors.initials: OH
authors.lastname: Skjeldal
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017668:Age of Onset; D002526:Cerebellar Diseases / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D009460:Neurologic Examination; D009664:Norway; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D016899:Interferon-beta
keywords: Children; Demyelinisation; Differential diagnosis; Multiple sclerosis