title: Characteristics of Children and Adolescents With Multiple Sclerosis.
abstract: To describe the demographic and clinical characteristics of pediatric multiple sclerosis (MS) in the United States.
  
  
  
  This prospective observational study included children and adolescents with MS. Cases were evaluated across 9 geographically diverse sites as part of the US Network of Pediatric MS Centers.
  
  
  
  A total of 490 children and adolescents (324 girls, 166 boys) were enrolled; 28% developed symptoms before 12 years of age. The proportion of girls increased with age from 58% (<12 years) to 70% (≥12 years). Race and ethnicity as self-identified were: white, 67%; African American, 21%; and non-Hispanic, 70%. Most (94%) of the cases were born in the United States, and 39% had 1 or both foreign-born parents. Fifty-five percent of cases had a monofocal presentation; 31% had a prodrome (most frequently infectious), most often among those aged <12 years (P < .001). Children aged <12 years presented more commonly with encephalopathy and coordination problems (P < .001). Sensory symptoms were more frequently reported by older children (ie, those aged ≥12 years) (P < .001); 78% of girls had MS onset postmenarche. The initial Expanded Disability Status Scale score for the group was <3.0, and the annualized relapse rate was 0.647 for the first 2 years. Interval from symptom onset to diagnosis and from diagnosis to initiation of disease-modifying therapy was longer among those <12 years of age.
  
  
  
  Pediatric MS in the United States is characterized by racial and ethnic diversity, a high proportion of children with foreign-born parents, and differences in clinical features and timing of treatment among those <12 years of age compared with older children.
authors.affiliation: Department of Neurology, Stony Brook University, Stony Brook, New York; NYU Langone Multiple Sclerosis Comprehensive Care Center, New York, New York; abelman@stonybrookmedicine.edu.
authors.forename: Anita L
authors.initials: AL
authors.lastname: Belman
authors.affiliation: NYU Langone Multiple Sclerosis Comprehensive Care Center, New York, New York;
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Krupp
authors.affiliation: Departments of Pediatrics and.
authors.forename: Cody S
authors.initials: CS
authors.lastname: Olsen
authors.affiliation: Neurology, University of Utah, Salt Lake City, Utah;
authors.forename: John W
authors.initials: JW
authors.lastname: Rose
authors.affiliation: Pediatric Multiple Sclerosis Center, Loma Linda University Children's Hospital, Loma Linda, California;
authors.forename: Greg
authors.initials: G
authors.lastname: Aaen
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Leslie
authors.initials: L
authors.lastname: Benson
authors.affiliation: Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, Massachusetts;
authors.forename: Tanuja
authors.initials: T
authors.lastname: Chitnis
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Mark
authors.initials: M
authors.lastname: Gorman
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, California;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Graves
authors.affiliation: University of Alabama Center for Pediatric Onset Demyelinating Disease, Children's Hospital of Alabama, Birmingham, Alabama;
authors.forename: Yolander
authors.initials: Y
authors.lastname: Harris
authors.affiliation: Blue Bird Circle Multiple Sclerosis Center, Baylor College of Medicine, Houston, Texas;
authors.forename: Tim
authors.initials: T
authors.lastname: Lotze
authors.affiliation: University of Alabama Center for Pediatric Onset Demyelinating Disease, Children's Hospital of Alabama, Birmingham, Alabama;
authors.forename: Jayne
authors.initials: J
authors.lastname: Ness
authors.affiliation: Mayo Clinic's Pediatric Multiple Sclerosis Center, Mayo Clinic, Rochester, Minnesota;
authors.forename: Moses
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Mayo Clinic's Pediatric Multiple Sclerosis Center, Mayo Clinic, Rochester, Minnesota;
authors.forename: Jan-Mendelt
authors.initials: JM
authors.lastname: Tillema
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, California; Department of Pediatrics, Benioff Children's Hospital, San Francisco, California; and.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Waubant
authors.affiliation: Pediatric Multiple Sclerosis Center, Jacobs Neurologic Institute, Buffalo, New York.
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.affiliation: Departments of Pediatrics and.
authors.forename: T Charles
authors.initials: TC
authors.lastname: Casper
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D044469:Racial Groups; D014481:United States / Q000453:epidemiology