Venkateswaran Sunita, Banwell Brenda
Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada M5G 1X8.
Neurologist. 2010 Mar;16(2):92-105. doi: 10.1097/NRL.0b013e3181c923d5.
Pediatric multiple sclerosis (MS), once considered a rare childhood illness, has been increasingly identified as an important childhood acquired neurologic disease requiring early recognition and intervention.
We present a comprehensive review of the current terminology of acquired central nervous system demyelination in children, pertinent investigations, including magnetic resonance imaging and cerebrospinal fluid cerebrospinal fluid studies, and an approach to the differential diagnosis of pediatric onset MS. In addition, the recent studies exploring the epidemiology and pathobiology will be discussed. Finally, we present an algorithm for the treatment of episodes of demyelination along with chronic immunomodulatory therapeutic options in this patient population.
Although some similarities exist to adult onset MS, MS onset during childhood and adolescence presents unique diagnostic challenges and requires specialized multidisciplinary care for optimal management. National and international collaborative studies are underway to aid in the understanding of the early and ongoing pathogenesis of MS.
小儿多发性硬化症(MS)曾被认为是一种罕见的儿童疾病,如今越来越多地被视为一种需要早期识别和干预的重要儿童获得性神经系统疾病。
我们对儿童获得性中枢神经系统脱髓鞘的当前术语、相关检查(包括磁共振成像和脑脊液研究)以及小儿起病型MS的鉴别诊断方法进行了全面综述。此外,还将讨论近期探索流行病学和病理生物学的研究。最后,我们提出了针对该患者群体脱髓鞘发作的治疗算法以及慢性免疫调节治疗方案。
尽管小儿起病型MS与成人起病型MS存在一些相似之处,但儿童和青少年期起病的MS存在独特的诊断挑战,需要专门的多学科护理以实现最佳管理。国内和国际合作研究正在进行中,以帮助了解MS的早期和持续发病机制。