Multiple sclerosis in Belgian children: A multicentre retrospective study.
BACKGROUND
Although the diagnosis of multiple sclerosis (MS) in the paediatric population remains challenging, paediatric-onset MS is increasingly recognized worldwide.


METHODS
We report on the clinical and biochemical features of a Belgian multicentre cohort of paediatric MS patients in a national retrospective descriptive study.


RESULTS
Twenty one paediatric MS patients from four Belgian University Hospitals were included. In nine patients, onset of MS was before the age of ten years which makes the study cohort of special interest. We report a higher incidence of acute disseminated encephalomyelitis (ADEM)-like first MS attacks and an overall higher proportion of polysymptomatic episodes than in adult and most paediatric cohorts reported in the literature. The clinical presentation in our cohort was rather severe with high median EDSS-score during the first clinical manifestation and barely more than half of our study patients showing full recovery after their first clinical manifestation. Also, a significant proportion of children in our cohort has severe disease progression despite disease modifying therapy and 9.5% of patients showed transition to secondary progressive multiple sclerosis during adolescence.


CONCLUSIONS
An early and correct diagnosis of paediatric MS is essential to start early adequate treatment. As illustrated by our study cohort, current treatment options in childhood are unsatisfactory.
Department of Paediatrics, Division of Paediatric Neurology, Ghent University Hospital, Ghent, Belgium. Electronic address: helene.verhelst@ugent.be.
Helene
H
Verhelst
KU Leuven, Department of Development and Regeneration, Campus Kulak Kortrijk, Kortrijk, Belgium; Department of Paediatric Neurology, University Hospitals Leuven, Leuven, Belgium. Electronic address: liesbeth.dewaele@uzleuven.be.
Liesbeth
L
De Waele
Department of Paediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola (U.L.B.), Brussels, Belgium. Electronic address: Nicolas.DECONINCK@huderf.be.
Nicolas
N
Deconinck
Department of Neurology-Paediatric Neurology, Antwerp University Hospital, University of Antwerp, Belgium. Electronic address: Berten.Ceulemans@uza.be.
Berten
B
Ceulemans
Department of Neurology, Antwerp University Hospital, Edegem, Belgium; Department of Neurology, Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium. Electronic address: Barbara.Willekens@uza.be.
Barbara
B
Willekens
Department of Paediatrics, Division of Paediatric Neurology, Ghent University Hospital, Ghent, Belgium. Electronic address: rudy.vancoster@ugent.be.
Rudy
R
Van Coster
D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D009902:Optic Neuritis / Q000150:complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies
Adolescence; Childhood; Multiple sclerosis; Paediatric multiple sclerosis