Skip to main content
SpringerLink
Log in

Pediatric Multiple Sclerosis

  • Chapter
  • First Online:
Clinical Neuroimmunology

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 1669 Accesses

Abstract

Pediatric multiple sclerosis (MS) has long been an under-recognized MS ­subgroup. Fortunately, the special diagnostic challenges, the clinical course, treatment, and special needs of this MS subgroup are receiving increased attention. Pediatric MS occurs in most of the world although the frequency varies. Differential diagnoses such as the distinction from acute disseminated encephalomyelitis (ADEM) differ from adults. The pathogenic mechanisms remain unclear with respect to pediatric MS. The strongest association of pediatric MS is with remote EBV infection, possibly reflecting heightened immune activation or reactivation of EBV. Certain clinical aspects of pediatric MS overlap with adults but there are often differences particularly in the younger children in clinical, radiologic, and laboratory manifestations. Unfortunately, there is a sizable proportion of children and adolescents who are very vulnerable to cognitive dysfunction in addition to other psychosocial stresses. The family unit is critically important in this age group and plays a different role than in adult MS. Management is complicated by the lack of clinical trials specific to children. Nonetheless, experience in evaluating and treating children has rapidly grown. The current review summarizes this experience.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Duquette P, Murray TJ, Pleines J, et al. Multiple sclerosis in childhood: clinical profile in 125 patients. J Pediatr. 1987;111:359–63.

    PubMed  CAS  Google Scholar 

  2. Boiko A, Vorobeychik G, Paty D, Devonshire V, Sadovnick D. Early onset multiple sclerosis: a longitudinal study. Neurology. 2002;59:1006–10.

    PubMed  CAS  Google Scholar 

  3. Ghezzi A, Deplano V, Faroni J, et al. Multiple sclerosis in childhood: clinical features of 149 cases. Mult Scler. 1997;3:43–6.

    PubMed  CAS  Google Scholar 

  4. Sindern E, Haas J, Stark E, Wurster U. Early onset MS under the age of 16: clinical and paraclinical features. Acta Neurol Scand. 1992;86:280–4.

    PubMed  CAS  Google Scholar 

  5. Ruggieri M, Polizzi A, Pavone L, Grimaldi LM. Multiple sclerosis in children under 6 years of age. Neurology. 1999;53:478–84.

    PubMed  CAS  Google Scholar 

  6. Renoux C, Vukusic S, Mikaeloff Y, et al. Natural history of multiple sclerosis with childhood onset. N Engl J Med. 2007;356:2603–13.

    PubMed  CAS  Google Scholar 

  7. Simone IL, Carrara D, Tortorella C, et al. Course and prognosis in early-onset MS: comparison with adult-onset forms. Neurology. 2002;59:1922–8.

    PubMed  CAS  Google Scholar 

  8. Chitnis T, Glanz B, Jaffin S, Healy B. Demographics of pediatric-onset multiple sclerosis in an MS center population from the Northeastern United States. Mult Scler. 2009;15:627–31.

    PubMed  CAS  Google Scholar 

  9. Compston A. McAlpine’s multiple sclerosis. 3rd ed. London: Churchill Livingston; 1998.

    Google Scholar 

  10. Banwell B, Kennedy J, Sadovnick D, et al. Incidence of acquired demyelination of the CNS in Canadian children. Neurology. 2009;72:232–9.

    PubMed  CAS  Google Scholar 

  11. Banwell B, Ghezzi A, Bar-Or A, Mikaeloff Y, Tardieu M. Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directions. Lancet Neurol. 2007;6:887–902.

    PubMed  Google Scholar 

  12. Deryck O, Ketelaer P, Dubois B. Clinical characteristics and long term prognosis in early onset multiple sclerosis. J Neurol. 2006;252:720–3.

    Google Scholar 

  13. Boster AL, Endress CF, Hreha SA, Caon C, Perumal JS, Khan OA. Pediatric-onset multiple sclerosis in African-American black and European-origin white patients. Pediatr Neurol. 2009;40:31–3.

    PubMed  Google Scholar 

  14. Krupp L. Racial and ethnic findings in pediatric MS: an update. Neurology. 2008;S70:A135.

    Google Scholar 

  15. Dale RC, de Sousa C, Chong WK, Cox TC, Harding B, Neville BG. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children. Brain. 2000;123(Pt 12):2407–22.

    PubMed  Google Scholar 

  16. Neuteboom RF, Boon M, Catsman Berrevoets CE, et al. Prognostic factors after a first attack of inflammatory CNS demyelination in children. Neurology. 2008;71:967–73.

    PubMed  CAS  Google Scholar 

  17. Mikaeloff Y, Suissa S, Vallee L, et al. First episode of acute CNS inflammatory demyelination in childhood: prognostic factors for multiple sclerosis and disability. J Pediatr. 2004;144:246–52.

    PubMed  Google Scholar 

  18. Dale RC, Brilot F, Banwell B. Pediatric central nervous system inflammatory demyelination: acute disseminated encephalomyelitis, clinically isolated syndromes, neuromyelitis optica, and multiple sclerosis. Curr Opin Neurol. 2009;22:233–40.

    PubMed  Google Scholar 

  19. Mikaeloff Y, Caridade G, Husson B, Suissa S, Tardieu M. Acute disseminated encephalomyelitis cohort study: prognostic factors for relapse. Eur J Paediatr Neurol. 2007;11:90–5.

    PubMed  Google Scholar 

  20. Dale RC, Pillai SC. Early relapse risk after a first CNS inflammatory demyelination episode: examining international consensus definitions. Dev Med Child Neurol. 2007;49:887–93.

    PubMed  Google Scholar 

  21. Bonhomme GR, Waldman AT, Balcer LJ, et al. Pediatric optic neuritis: brain MRI abnormalities and risk of multiple sclerosis. Neurology. 2009;72:881–5.

    PubMed  CAS  Google Scholar 

  22. Wilejto M, Shroff M, Buncic JR, Kennedy J, Goia C, Banwell B. The clinical features, MRI findings, and outcome of optic neuritis in children. Neurology. 2006;67:258–62.

    PubMed  CAS  Google Scholar 

  23. Lucchinetti CF, Kiers L, O’Duffy A, et al. Risk factors for developing multiple sclerosis after childhood optic neuritis. Neurology. 1997;49:1413–8.

    PubMed  CAS  Google Scholar 

  24. Alper G, Wang L. Demyelinating optic neuritis in children. J Child Neurol. 2009;24:45–8.

    PubMed  Google Scholar 

  25. McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001;50:121–7.

    PubMed  CAS  Google Scholar 

  26. Mikaeloff Y, Adamsbaum C, Husson B, et al. MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. Brain. 2004;127:1942–7.

    PubMed  Google Scholar 

  27. Callen DJ, Shroff MM, Branson HM, et al. MRI in the diagnosis of pediatric multiple sclerosis. Neurology. 2009;72:961–7.

    PubMed  CAS  Google Scholar 

  28. Ozakbas S, Idiman E, Baklan B, Yulug B. Childhood and juvenile onset multiple sclerosis: clinical and paraclinical features. Brain Dev. 2003;25:233–6.

    PubMed  Google Scholar 

  29. Ghezzi A, Pozzilli C, Liguori M, et al. Prospective study of multiple sclerosis with early onset. Mult Scler. 2002;8:115–8.

    PubMed  CAS  Google Scholar 

  30. Gusev E, Boiko A, Bikova O, et al. The natural history of early onset multiple sclerosis: comparison of data from Moscow and Vancouver. Clin Neurol Neurosurg. 2002;104:203–7.

    PubMed  Google Scholar 

  31. Banwell B, Krupp L, Kennedy J, et al. Clinical features and viral serologies in children with multiple sclerosis: a multinational observational study. Lancet Neurol. 2007;6:773–81.

    PubMed  Google Scholar 

  32. Pohl D, Rostasy K, Treiber-Held S, Brockmann K, Gartner J, Hanefeld F. Pediatric multiple sclerosis: detection of clinically silent lesions by multimodal evoked potentials. J Pediatr. 2006;149:125–7.

    PubMed  Google Scholar 

  33. Mikaeloff Y, Caridade G, Assi S, Suissa S, Tardieu M. Prognostic factors for early severity in a childhood multiple sclerosis cohort. Pediatrics. 2006;118:1133–9.

    PubMed  Google Scholar 

  34. Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology. 2002;59:1224–31.

    PubMed  Google Scholar 

  35. Chabas D, Castillo-Trivino T, Mowry EM, Strober JB, Glenn OA, Waubant E. Vanishing MS T2-bright lesions before puberty: a distinct MRI phenotype? Neurology. 2008;71:1090–3.

    PubMed  CAS  Google Scholar 

  36. Chabas D, Ness J, Belman A, et al. Younger children with pediatric MS have a distinct CSF inflammatory profile at disease onset. Neurology. 2010;74(5):399–405.

    PubMed  CAS  Google Scholar 

  37. MacAllister WS, Krupp LB. Multiple sclerosis-related fatigue. Phys Med Rehabil Clin N Am. 2005;16:483–502.

    PubMed  Google Scholar 

  38. Amato MP, Goretti B, Ghezzi A, et al. Cognitive and psychosocial features of childhood and juvenile MS. Neurology. 2008;70:1891–7.

    PubMed  CAS  Google Scholar 

  39. MacAllister W, Milazzo M, Troxell RM, et al. Fatigue and quality of life in pediatric multiple sclerosis. Ann Neurol. 2006;60:S39.

    Google Scholar 

  40. MacAllister WS, Belman AL, Milazzo M, et al. Cognitive functioning in children and adolescents with multiple sclerosis. Neurology. 2005;64:1422–5.

    PubMed  CAS  Google Scholar 

  41. Banwell BL, Anderson PE. The cognitive burden of multiple sclerosis in children. Neurology. 2005;64:891–4.

    PubMed  Google Scholar 

  42. MacAllister WS, Christodoulou C, Milazzo M, Krupp LB. Longitudinal neuropsychological assessment in pediatric multiple sclerosis. Dev Neuropsychol. 2007;32:625–44.

    PubMed  Google Scholar 

  43. Amato M. Cognitive and psychosocial features of childhood and juvenile multiple sclerosis: a reappraisal after 2 years. Neurology. 2009;3:A97.

    Google Scholar 

  44. Pohl D, Rostasy K, Gartner J, Hanefeld F. Treatment of early onset multiple sclerosis with subcutaneous interferon beta-1a. Neurology. 2005;64:888–90.

    PubMed  CAS  Google Scholar 

  45. Ghezzi A, Amato MP, Capobianco M, et al. Disease-modifying drugs in childhood-juvenile multiple sclerosis: results of an Italian co-operative study. Mult Scler. 2005;11:420–4.

    PubMed  CAS  Google Scholar 

  46. Tenembaum S, Chitnis T, Ness J, Hahn JS. Acute disseminated encephalomyelitis. Neurology. 2007;68:S23–36.

    PubMed  Google Scholar 

  47. Wingerchuk DM, Lucchinetti CF. Comparative immunopathogenesis of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis. Curr Opin Neurol. 2007;20:343–50.

    PubMed  Google Scholar 

  48. Filippi M, Rocca MA. MRI evidence for multiple sclerosis as a diffuse disease of the central nervous system. J Neurol. 2005;252 Suppl 5:v16–24.

    PubMed  Google Scholar 

  49. Krupp LB, Banwell B, Tenembaum S. Consensus definitions proposed for ­pediatric multiple sclerosis and related disorders. Neurology. 2007;68:S7–12.

    PubMed  Google Scholar 

  50. Brass SD, Caramanos Z, Santos C, Dilenge ME, Lapierre Y, Rosenblatt B. Multiple sclerosis vs acute disseminated encephalomyelitis in childhood. Pediatr Neurol. 2003;29:227–31.

    PubMed  Google Scholar 

  51. Tenembaum S, Chitnis T, Ness J, Hahn JS, Group IPMS. Acute disseminated encephalomyelitis. Neurology. 2007;68:S23–36.

    PubMed  Google Scholar 

  52. Callen DJ, Shroff MM, Branson HM, et al. Role of MRI in the differentiation of ADEM from MS in children. Neurology. 2009;72:968–73.

    PubMed  CAS  Google Scholar 

  53. Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ. Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology. 2001;56:1308–12.

    PubMed  CAS  Google Scholar 

  54. Banwell B, Tenembaum S, Lennon VA, et al. Neuromyelitis optica-IgG in ­childhood inflammatory demyelinating CNS disorders. Neurology. 2008;70:344–52.

    PubMed  CAS  Google Scholar 

  55. Hahn CD, Shroff MM, Blaser SI, Banwell BL. MRI criteria for multiple sclerosis: evaluation in a pediatric cohort. Neurology. 2004;62:806–8.

    PubMed  Google Scholar 

  56. Hahn JS, Pohl D, Rensel M, Rao S. Differential diagnosis and evaluation in pediatric multiple sclerosis. Neurology. 2007;68:S13–22.

    PubMed  Google Scholar 

  57. Van der Knaap MS. Magnetic resonance of myelination and myelin disorders. 3rd ed. New York: Springer; 2005.

    Google Scholar 

  58. Gorman MP, Golomb MR, Walsh LE, et al. Steroid-responsive neurologic relapses in a child with a proteolipid protein-1 mutation. Neurology. 2007;68:1305–7.

    PubMed  CAS  Google Scholar 

  59. Chitnis T. Pediatric multiple sclerosis. Neurologist. 2006;12:299–310.

    PubMed  Google Scholar 

  60. Mikaeloff Y, Caridade G, Suissa S, Tardieu M. Clinically observed chickenpox and the risk of childhood-onset multiple sclerosis. Am J Epidemiol. 2009;169:1260–6.

    PubMed  Google Scholar 

  61. Mikaeloff Y, Caridade G, Suissa S, Tardieu M. Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood. Neurology. 2009;72:873–80.

    PubMed  Google Scholar 

  62. Mikaeloff Y, Caridade G, Tardieu M, Suissa S. Parental smoking at home and the risk of childhood-onset multiple sclerosis in children. Brain. 2007;130:2589–95.

    PubMed  Google Scholar 

  63. Correale J, Tenembaum SN. Myelin basic protein and myelin oligodendrocyte glycoprotein T-cell repertoire in childhood and juvenile multiple sclerosis. Mult Scler. 2006;12:412–20.

    PubMed  CAS  Google Scholar 

  64. Banwell B, Bar-Or A, Cheung R, et al. Abnormal T-cell reactivities in childhood inflammatory demyelinating disease and type 1 diabetes. Ann Neurol. 2008;63:98–111.

    PubMed  Google Scholar 

  65. Barnes D, Hughes RA, Morris RW, et al. Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis. Lancet. 1997;349:902–6.

    PubMed  CAS  Google Scholar 

  66. Martinelli V, Pulizzi A, Annovazzi P, Rocca M, Rodegher M, et al. A short-term MRI study comparing high-dose oral versus intravenous methylpredisolone in MS relapse. Neurology. 2008;70:A83–4.

    Google Scholar 

  67. Morrow SA, Stoian CA, Dmitrovic J, Chan SC, Metz LM. The bioavailability of IV methylprednisolone and oral prednisone in multiple sclerosis. Neurology. 2004;63:1079–80.

    PubMed  CAS  Google Scholar 

  68. Weinshenker BG, O’Brien PC, Petterson TM, Noseworthy JH. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol. 1999;46:878–86.

    PubMed  CAS  Google Scholar 

  69. Duzova A, Bakkaloglu A. Central nervous system involvement in pediatric rheumatic diseases: current concepts in treatment. Curr Pharm Des. 2008;14:1295–301.

    PubMed  CAS  Google Scholar 

  70. Hahn JS, Siegler DJ, Enzmann D. Intravenous gammaglobulin therapy in recurrent acute disseminated encephalomyelitis. Neurology. 1996;46:1173–4.

    PubMed  CAS  Google Scholar 

  71. Nishikawa M, Ichiyama T, Hayashi T, Ouchi K, Furukawa S. Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis. Pediatr Neurol. 1999;21:583–6.

    PubMed  CAS  Google Scholar 

  72. Mikaeloff Y, Caridade G, Tardieu M, Suissa S. Effectiveness of early beta interferon on the first attack after confirmed multiple sclerosis: a comparative cohort study. Eur J Paediatr Neurol. 2008;12:205–9.

    PubMed  Google Scholar 

  73. Ghezzi A, Amato MP, Capobianco M, et al. Treatment of early-onset multiple sclerosis with intramuscular interferonbeta-1a: long-term results. Neurol Sci. 2007;28:127–32.

    PubMed  CAS  Google Scholar 

  74. Pakdaman H, Fallah A, Sahraian MA, Pakdaman R, Meysamie A. Treatment of early onset multiple sclerosis with suboptimal dose of interferon beta-1a. Neuropediatrics. 2006;37:257–60.

    PubMed  CAS  Google Scholar 

  75. Waubant E, Hietpas J, Stewart T, et al. Interferon beta-1a in children with multiple sclerosis is well tolerated. Neuropediatrics. 2001;32:211–3.

    PubMed  CAS  Google Scholar 

  76. Mikaeloff Y, Moreau T, Debouverie M, et al. Interferon-beta treatment in patients with childhood-onset multiple sclerosis. J Pediatr. 2001;139:443–6.

    PubMed  CAS  Google Scholar 

  77. Tenembaum SN, Segura MJ. Interferon beta-1a treatment in childhood and juvenile-onset multiple sclerosis. Neurology. 2006;67:511–3.

    PubMed  CAS  Google Scholar 

  78. Banwell B, Reder AT, Krupp L, et al. Safety and tolerability of interferon beta-1b in pediatric multiple sclerosis. Neurology. 2006;66:472–6.

    PubMed  CAS  Google Scholar 

  79. Adams AB, Tyor WR, Holden KR. Interferon beta-1b and childhood multiple sclerosis. Pediatr Neurol. 1999;21:481–3.

    PubMed  CAS  Google Scholar 

  80. Krupp L, Pardo L, Vitt D. Clinical features and disease-modifying therapy experience in paediatric multiple sclerosis. Mult Scler. 2004;10:S178.

    Google Scholar 

  81. Kornek B, Bernert G, Balassy C, Geldner J, Prayer D, Feucht M. Glatiramer acetate treatment in patients with childhood and juvenile onset multiple sclerosis. Neuropediatrics. 2003;34:120–6.

    PubMed  CAS  Google Scholar 

  82. Borriello G, Prosperini L, Luchetti A, Pozzilli C. Natalizumab treatment in pediatric multiple sclerosis: a case report. Eur J Paediatr Neurol. 2009;13(1):67–71.

    PubMed  Google Scholar 

  83. Huppke P, Stark W, Zurcher C, Huppke B, Bruck W, Gartner J. Natalizumab use in pediatric multiple sclerosis. Arch Neurol. 2008;65:1655–8.

    PubMed  Google Scholar 

  84. Yeh EA, Waubant E, Krupp L, Ness J, Chitnis T, Kuntz N, Ramanathan M, Belman A, Chabas D, Gorman M, Rodriguez M, Rinker J, Weinstock-Guttman B. MS Therapies in Pediatric MS Patients With Refractory Disease. Archives of Neurology 2011;68(4):437–444.

    Google Scholar 

  85. Makhani N, Gorman MP, Branson HM, Stazzone L, Banwell BL, Chitnis T. Cyclophosphamide therapy in pediatric multiple sclerosis. Neurology. 2009;72:2076–82.

    PubMed  CAS  Google Scholar 

  86. Krupp LB, Rizvi SA. Symptomatic therapy for underrecognized manifestations of multiple sclerosis. Neurology. 2002;58:S32–9.

    PubMed  CAS  Google Scholar 

  87. Murray TJ. Amantadine therapy for fatigue in multiple sclerosis. Can J Neurol Sci. 1985;12:251–4.

    PubMed  CAS  Google Scholar 

  88. Krupp LB, Coyle PK, Doscher C, et al. Fatigue therapy in multiple sclerosis: results of a double-blind, randomized, parallel trial of amantadine, pemoline, and placebo. Neurology. 1995;45:1956–61.

    PubMed  CAS  Google Scholar 

  89. A randomized controlled trial of amantadine in fatigue associated with multiple sclerosis. The Canadian MS Research Group. Can J Neurol Sci. 1987;14:273–8.

    Google Scholar 

  90. Rammohan KW, Lynn DJ. Modafinil for fatigue in MS: a randomized placebo-controlled double-blind study. Neurology. 2005;65:1995–7. author reply 1995–7.

    PubMed  Google Scholar 

  91. Zifko UA, Rupp M, Schwarz S, Zipko HT, Maida EM. Modafinil in treatment of fatigue in multiple sclerosis. Results of an open-label study. J Neurol. 2002;249:983–7.

    PubMed  CAS  Google Scholar 

  92. Weinshenker BG, Penman M, Bass B, Ebers GC, Rice GP. A double-blind, randomized, crossover trial of pemoline in fatigue associated with multiple sclerosis. Neurology. 1992;42:1468–71.

    PubMed  CAS  Google Scholar 

  93. Pucci E, Branas P, D’Amico R, Giuliani G, Solari A, Taus C. Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2007;(1):CD002818.

    Google Scholar 

  94. Rammohan KW, Rosenberg JH, Lynn DJ, Blumenfeld AM, Pollak CP, Nagaraja HN. Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. J Neurol Neurosurg Psychiatry. 2002;72:179–83.

    PubMed  CAS  Google Scholar 

  95. Stankoff B, Waubant E, Confavreux C, et al. Modafinil for fatigue in MS: a randomized placebo-controlled double-blind study. Neurology. 2005;64:1139–43.

    PubMed  CAS  Google Scholar 

  96. Krupp LB, Christodoulou C, Melville P, Scherl WF, MacAllister WS, Elkins LE. Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology. 2004;63:1579–85.

    PubMed  CAS  Google Scholar 

  97. O’Brien AR, Chiaravalloti N, Goverover Y, Deluca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. Arch Phys Med Rehabil. 2008;89:761–9.

    PubMed  Google Scholar 

  98. Cheung AH, Emslie GJ, Mayes TL. The use of antidepressants to treat depression in children and adolescents. CMAJ. 2006;174:193–200.

    PubMed  Google Scholar 

  99. de Seze M, Ruffion A, Denys P, Joseph PA, Perrouin-Verbe B. The neurogenic bladder in multiple sclerosis: review of the literature and proposal of management guidelines. Mult Scler. 2007;13:915–28.

    PubMed  Google Scholar 

  100. Chia YW, Fowler CJ, Kamm MA, Henry MM, Lemieux MC, Swash M. Prevalence of bowel dysfunction in patients with multiple sclerosis and bladder dysfunction. J Neurol. 1995;242:105–8.

    PubMed  CAS  Google Scholar 

  101. Nortvedt MW, Riise T, Frugard J, et al. Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult Scler. 2007;13:106–12.

    PubMed  CAS  Google Scholar 

  102. DasGupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs. 2003;63:153–66.

    PubMed  CAS  Google Scholar 

  103. Hansel DE, Hansel CR, Shindle MK, et al. Oral baclofen in cerebral palsy: possible seizure potentiation? Pediatr Neurol. 2003;29:203–6.

    PubMed  Google Scholar 

  104. Sgouros S, Seri S. The effect of intrathecal baclofen on muscle co-contraction in children with spasticity of cerebral origin. Pediatr Neurosurg. 2002;37:225–30.

    PubMed  CAS  Google Scholar 

  105. Gronseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71(15):1183–90.

    PubMed  CAS  Google Scholar 

  106. Goodman AD, Cohen JA, Cross A, et al. Fampridine-SR in multiple sclerosis: a randomized, double-blind, placebo-controlled, dose-ranging study. Mult Scler. 2007;13:357–68.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Stony Brook University Medical Center, Stony Brook, NY, USA

    Lauren Krupp, Yashma Patel & Vikram Bhise

Authors
  1. Lauren Krupp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yashma Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vikram Bhise
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. , Department of Clinical Neuroscience, Brown University, Dudley Street 2, Providence, 02905, Rhode Island, USA

    Syed A. Rizvi

  2. Stony Brook Medical Center, Department of Neurology, State University of New York, Belle Meade Rd. 179, East Setauket, 11733, New York, USA

    Patricia K. Coyle

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Krupp, L., Patel, Y., Bhise, V. (2011). Pediatric Multiple Sclerosis. In: Rizvi, S., Coyle, P. (eds) Clinical Neuroimmunology. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-60327-860-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-860-7_8

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-859-1

  • Online ISBN: 978-1-60327-860-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation