Division of Pediatric Neurology, Chang Gung Children's Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, .
Biomed J. 2014 Mar-Apr;37(2):50-9. doi: 10.4103/2319-4170.129269.
Pediatric multiple sclerosis (MS) represents only 2-5% of the MS population, but children with MS have a higher relapse rate and reach permanent disability at a younger age than adult-onset MS. Early and accurate diagnosis of pediatric MS is vital for prompt treatment to mitigate ongoing neuroinflammation and irreversible neurodegeneration. However, it is difficult to differentiate MS from acute disseminated encephalomyelitis (ADEM) and neuromyelitis optica (NMO) in pediatric patients, even considering the clinical, magnetic resonance imaging (MRI), and paraclinical findings, because the first presentation of inflammatory demyelination in children is often atypical. The purpose of this review is to summarize the clinical, neuroimaging, and paraclinical key differences between pediatric patients with MS, ADEM, and NMO and to discuss novel biomarkers, such as antibodies to aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG), which may help in making a diagnosis.
儿科多发性硬化症 (MS) 仅占 MS 患者的 2-5%，但儿童 MS 的复发率更高，且比成人 MS 更早达到永久性残疾。早期、准确地诊断儿科 MS 对于及时治疗以减轻持续的神经炎症和不可逆转的神经退行性变至关重要。然而，即使考虑到临床、磁共振成像 (MRI) 和辅助检查结果，儿科患者也很难将 MS 与急性播散性脑脊髓炎 (ADEM) 和视神经脊髓炎 (NMO) 区分开来，因为儿童的炎症性脱髓鞘首发表现往往是非典型的。本文的目的是总结 MS、ADEM 和 NMO 儿科患者之间在临床、神经影像学和辅助检查方面的关键差异，并讨论新的生物标志物，如抗水通道蛋白 4 (AQP4) 和髓鞘少突胶质细胞糖蛋白 (MOG) 抗体，这些标志物可能有助于诊断。
