Onset symptoms in paediatric multiple sclerosis.

INTRODUCTION Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare symptoms and paraclinical findings at the first demyelinating event in paediatric MS with those of an adult MS population. MATERIAL AND METHODS A total of 18 subjects with onset of MS relapse before 16 years of age were retrospectively included in the study. Case records were reviewed for symptoms at disease onset, cerebrospinal fluid findings, magnetic resonance imaging (MRI) and evoked potentials at the first demyelinating event. These data were compared with similar nationwide data from adults in Denmark. RESULTS The median age was 14 (range 10-15) years at the first demyelinating event and the mean time to MS diagnosis was 1.7 years. The majority of children had sensory symptoms (47%; 95% confidence interval (CI): 23-72%) or optic neuritis (35%; CI: 14-62%) as their presenting symptoms. These results did not differ from the findings in adult MS subjects. Pleocytosis was present in 93% (CI: 66-100%) of paediatric MS subjects, 77% (CI: 46-95%) had an elevated IgG index and 85% (CI: 55-98%) had oligoclonal bands in the cerebrospinal fluid. MRI showed characteristic white matter lesions in all children (CI: 80-100%). CONCLUSION MS symptoms at the first demyelinating event and diagnostic delay in paediatric MS subjects do not differ significantly from those seen in an adult MS population. FUNDING not relevant. TRIAL REGISTRATION not relevant.