Chitnis Tanuja
Massachusetts General Hospital, Department of Child Neurology, Boston, MA 02114, USA.
Continuum (Minneap Minn). 2013 Aug;19(4 Multiple Sclerosis):1023-45. doi: 10.1212/01.CON.0000433285.84973.43.
In the past decade, the number of studies related to demyelinating diseases in children has exponentially increased. Demyelinating disease in children may be monophasic or chronic. Typical monophasic disorders in children are acute disseminated encephalomyelitis and clinically isolated syndromes, including optic neuritis and transverse myelitis. However, some cases of acute disseminated encephalomyelitis or clinically isolated syndrome progress to become chronic disorders, including multiple sclerosis and neuromyelitis optica. This review summarizes the current knowledge on monophasic and chronic demyelinating disorders in children, focusing on an approach to diagnosis and management.
Improved diagnostic definitions for pediatric demyelinating diseases have led to enhanced recognition of these disorders. Additionally, increased awareness and focused national and international efforts continue to inform about the clinical course, response to treatment, and disease pathogenesis.
Significant advances have been made in the recognition, diagnosis, and management of pediatric demyelinating disorders over the past 10 years. This review summarizes these advances and provides an updated approach to the diagnosis and management of pediatric demyelinating disorders.
在过去十年中，有关儿童脱髓鞘疾病的研究数量呈指数级增长。儿童脱髓鞘疾病可能是单相的或慢性的。儿童典型的单相疾病是急性播散性脑脊髓炎和临床孤立综合征，包括视神经炎和横贯性脊髓炎。然而，一些急性播散性脑脊髓炎或临床孤立综合征病例会进展为慢性疾病，包括多发性硬化症和视神经脊髓炎。本综述总结了目前关于儿童单相和慢性脱髓鞘疾病的知识，重点是诊断和管理方法。
儿童脱髓鞘疾病诊断定义的改进提高了对这些疾病的认识。此外，意识的提高以及国家和国际层面的重点努力持续为临床病程、治疗反应和疾病发病机制提供信息。
在过去10年中，儿童脱髓鞘疾病的识别、诊断和管理取得了重大进展。本综述总结了这些进展，并提供了儿童脱髓鞘疾病诊断和管理的最新方法。
