Waldman Amy T, Gorman Mark P, Rensel Mary R, Austin Tracy E, Hertz Deborah P, Kuntz Nancy L
Department of Pediatrics, Children's Hospital of Philadelphia and Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Child Neurol. 2011 Jun;26(6):675-82. doi: 10.1177/0883073810395141. Epub 2011 Apr 25.
Demyelinating diseases are a group of autoimmune inflammatory disorders affecting the central nervous system in adults and children; however, the diagnosis, evaluation, and treatment of these disorders are primarily based on adult data. The purpose of this study was to assess the practice patterns of US physicians who specialize in treating acquired central nervous system demyelinating diseases in children and adolescents. The Delphi technique was used to identify areas of consensus in management and treatment. Forty-two experts in the field participated in the process. Intravenous methylprednisolone was the first-line treatment of choice for acute episodes of all forms of demyelinating disease; however, consensus was lacking regarding specific dose, treatment duration, and use of an oral taper. First-line disease-modifying therapies for pediatric multiple sclerosis were interferons and glatiramer acetate, chosen based on perceived efficacy and tolerability, respectively. Areas lacking agreement among the expert panel and requiring further research are identified.
脱髓鞘疾病是一组影响成人和儿童中枢神经系统的自身免疫性炎症性疾病；然而，这些疾病的诊断、评估和治疗主要基于成人数据。本研究的目的是评估专门治疗儿童和青少年获得性中枢神经系统脱髓鞘疾病的美国医生的实践模式。采用德尔菲技术确定管理和治疗方面的共识领域。该领域的42位专家参与了这一过程。静脉注射甲基强的松龙是所有形式脱髓鞘疾病急性发作的一线治疗选择；然而，在具体剂量、治疗持续时间和口服逐渐减量的使用方面缺乏共识。儿童多发性硬化症的一线疾病修饰疗法是干扰素和醋酸格拉替雷，分别根据感知到的疗效和耐受性选择。确定了专家小组之间缺乏共识且需要进一步研究的领域。
