- 作者：H. Verhelst ; L. De Waele ; N. Deconinck ; B. Ceulemans ; B. Willekens ; R. Van Coster
- 刊名：European Journal of Paediatric Neurology
- 出版年：2015
- 出版时间：May 2015
- 年：2015
- 卷：19
- 期：supp_S1
- 页码：S62
- 全文大小：78 K
Methods
ra20">Twenty one pediatric multiple sclerosis (MS) records from four Belgian University Hospitals were retrospectively analyzed.
Results
ra30">The study population consists of twenty one MS patients (nine male and twelve female). Median age at presentation was eleven years. In 23.8% of the patients, disease onset was preceded by an infection. One patient (4.8%) had a positive familial history of MS. Seroconversion for Epstein-Barr virus was seen in 93.3%. One third of the patients presented monosymptomatic, 57.1% with vision impairment most frequently due to optic neuritis. An acute disseminated encephalomyelitis-like presentation was seen in 19%. The median time lapse between disease onset and first relapse was eight months, and between disease onset and diagnosis nine months. At diagnosis, all patients had relapsing remitting MS. Median relapse rate was 0.93/year. Most relapses were severe but recovery was complete in most patients. Cerebral MRI at disease onset revealed a median of eight lesions (66.7% juxtacortical, 66.7% infratentorial and 44.4% periventricular). In 19% of the patients, MRI of the spinal cord was performed showing lesions in 75%. In cerebrospinal fluid, white blood cells were increased in 52.6%, IgG-index was increased in 44.4% and oligoclonal bands were detected in 68.4%. Disease modifying therapy was initiated in 71.4% of the patients after a median disease duration of 15.5 months, at a median age of 12.5 years. The median duration of follow-up was 53 months. At last follow-up visit, 19% had reached an EDSS score of three and 9.5% had evolved to secondary progressive MS (SPMS).
Conclusion
ra40">The presented study cohort illustrates the clinical and laboratory features of paediatric MS highlighting a high incidence of positive Epstein-Barr virus serology and the severity of the disease course with in 9.5% evolution to SPMS.