Skip to main content

Paediatric multiple sclerosis: The experience of the German Centre for Multiple Sclerosis in Childhood and Adolescence

Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system and the most common disabling neurological disease in young adults. An estimated 5 % of MS patients already have first clinical symptoms before the age of 16 years (paediatric MS). In the paediatric age group comprehensive analysis of the natural clinical course and the course under treatment in a large MS cohort is still missing. We describe a cohort of paediatric MS patients treated in the German Centre for Multiple Sclerosis in Childhood and Adolescence. A total of 166 patients with definite MS who are registered in our database were analysed. The observation time was up to 14.9 years with a mean follow-up of 4.1 years. Median age was 12.4 years (range 4 to 18 years). Prior to puberty the gender ratio was almost equal, while in adolescence there was a strong female predominance as is seen in adult onset MS. Almost all patients presented with relapsing- remitting MS. The course of the disease was more benign than in adult MS with a very slow EDSS increase and complete remission after most relapses. Most patients received immunomodulative treatment with interferon-beta or glatiramer acetate and, in severe cases, natalizumab. However, adequate treatment guidelines for this age group are still lacking.

This is a preview of subscription content, access via your institution.

References

  1. Banwell B, Ghezzi A, Bar-Or A, MikaeloffY, Tardieu M (2007) Multiple sclerosisin children: clinical diagnosis,therapeutic strategies, and futuredirections. Lancet Neurol 6:887–902

    PubMed  Article  Google Scholar 

  2. Banwell B, Shroff M, Ness JM, Jeffery D,Schwid S, Weinstock-Guttman B (2007)MRI features of pediatric multiplesclerosis. Neurology 68:S46–S53

    PubMed  Article  CAS  Google Scholar 

  3. Boiko A, Vorobeychik G, Paty D,Devonshire V, Sadovnick D (2002)Early onset multiple sclerosis: a longitudinalstudy. Neurology 59:1006–1010

    PubMed  Article  CAS  Google Scholar 

  4. Deryck O, Ketelaer P, Dubois B (2006)Clinical characteristics and long termprognosis in early onset multiple sclerosis.J Neurol 253:720–723

    PubMed  Article  Google Scholar 

  5. Duquette P, Murray TJ, Pleines J, EbersGC, Sadovnick D, Weldon P, Warren S,Paty DW, Upton A, Hader W, et al.(1987) Multiple sclerosis in childhood:clinical profile in 125 patients. J Pediatr111:359–363

    PubMed  Article  CAS  Google Scholar 

  6. Ghezzi A, Deplano V, Faroni J, GrassoMG, Liguori M, Marrosu G, Pozzilli C,Simone IL, Zaffaroni M (1997) Multiplesclerosis in childhood: clinical featuresof 149 cases. Mult Scler 3:43–46

    PubMed  CAS  Article  Google Scholar 

  7. Ghezzi A, Pozzilli C, Liguori M,Marrosu MG, Milani N, Milanese C,Simone I, Zaffaroni M (2002) Prospectivestudy of multiple sclerosis withearly onset. Mult Scler 8:115–118

    PubMed  Article  CAS  Google Scholar 

  8. Mikaeloff Y, Adamsbaum C, Husson B,Vallee L, Ponsot G, Confavreux C,Tardieu M, Suissa S (2004) MRI prognosticfactors for relapse after acuteCNS inflammatory demyelination inchildhood. Brain 127:1942–1947

    PubMed  Article  Google Scholar 

  9. Ozakbas S, Idiman E, Baklan B, Yulug B(2003) Childhood and juvenile onsetmultiple sclerosis: clinical and paraclinicalfeatures. Brain Dev 25:233–236

    PubMed  Google Scholar 

  10. Pohl D, Hennemuth I, von Kries R,Hanefeld F (2007) Paediatric multiplesclerosis and acute disseminated encephalomyelitisin Germany: results ofa nationwide survey. Eur J Pediatr 166:405–412

    PubMed  Article  Google Scholar 

  11. Pohl D, Rostasy K, Reiber H, HanefeldF (2004) CSF characteristics in earlyonsetmultiple sclerosis. Neurology63:1966–1967

    PubMed  CAS  Google Scholar 

  12. Polman CH, Reingold SC, Edan G,Filippi M, Hartung HP, Kappos L,Lublin FD, Metz LM, McFarland HF,O’Connor PW, Sandberg-Wollheim M,Thompson AJ, Weinshenker BG,Wolinsky JS (2005) Diagnostic criteriafor multiple sclerosis: 2005 revisions tothe “McDonald Criteria”. Ann Neurol58:840–846

    PubMed  Article  Google Scholar 

  13. Simone IL, Carrara D, Tortorella C,Liguori M, Lepore V, Pellegrini F,Bellacosa A, Ceccarelli A, Pavone I,Livrea P (2002) Course and prognosisin early-onset MS: comparison withadult-onset forms. Neurology 59:1922–1928

    PubMed  CAS  Google Scholar 

  14. Sindern E, Haas J, Stark E, Wurster U(1992) Early onset MS under the age of16: clinical and paraclinical features.Acta Neurol Scand 86:280–284

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jutta Gärtner.

Additional information

* Equally contributing.

Conflict of interest W. Stark, P. Huppke and J. Gärtner have no conflict of interest to declare.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Stark*, W., Huppke*, P. & Gärtner, J. Paediatric multiple sclerosis: The experience of the German Centre for Multiple Sclerosis in Childhood and Adolescence. J Neurol 255, 119–122 (2008). https://doi.org/10.1007/s00415-008-6022-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-008-6022-x

Key words

  • multiple sclerosis
  • children and adolescents
  • clinical spectrum