title: Pediatric multiple sclerosis: Clinical features and outcome.
abstract: Multiple sclerosis (MS) in children manifests with a relapsing-remitting MS (RRMS) disease course. Acute relapses consist of new neurologic deficits persisting greater than 24 hours, in the absence of intercurrent illness, and occur with a higher frequency early in the disease as compared to adult-onset RRMS. Most pediatric patients with MS recover well from these early relapses, and cumulative physical disability is rare in the first 10 years of disease. Brainstem attacks, poor recovery from a single attack, and a higher frequency of attacks portend a greater likelihood of future disability. Although prospective pediatric-onset MS cohorts have been established in recent years, there remains very limited prospective data detailing the longer-term clinical outcome of pediatric-onset MS into adulthood. Whether the advent of MS therapies, and the largely off-label access to such therapies in pediatric MS, has improved prognosis is unknown. MS onset during the key formative academic years, concurrent with active cognitive maturation, is an important determinant of long-term outcome, and is discussed in detail in another article in this supplement. Finally, increasing recognition of pediatric MS worldwide, recent launch of phase III trials for new agents in the pediatric MS population, and the clear imperative to more fully appreciate health-related quality of life in pediatric MS through adulthood highlight the need for standardized, validated, and robust outcome measures.
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy. waldman@email.chop.edu.
authors: Amy
authors: A
authors: Waldman
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Jayne
authors: J
authors: Ness
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Daniela
authors: D
authors: Pohl
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Isabella Laura
authors: IL
authors: Simone
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Banu
authors: B
authors: Anlar
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Maria Pia
authors: MP
authors: Amato
authors: From the Division of Neurology, Department of Pediatrics (A.W.), Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Department of Pediatrics (J.N.), University of Alabama at Birmingham and Children's of Alabama; Department of Neurology (D.P.), Children's Hospital of Eastern Ontario, University of Ottawa, Canada; Department of Basic Medical Sciences, Neurosciences and Sense Organs (I.L.S.), University of Bari, Italy; Department of Pediatric Neurology (B.A.), Hacettepe University, Ankara, Turkey; Department NEUROFARBA, Section Neurosciences (M.P.A.), University of Florence; and Divisione di Neurologia 2-Centro Studi Sclerosi Multipla (A.G.), Ospedale di Gallarate, Italy.
authors: Angelo
authors: A
authors: Ghezzi
mesh_terms: D002648:Child; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010372:Pediatrics; D016896:Treatment Outcome