Araqi-Houssaini A, Dany F, Sekkat Z, Camara N A, Hazim A, Midafi N, Elotmani H, El Moutawakil B, Rafai M A, Slassi I
Service de neurologie, CHU Ibn Rochd, quartier des Hôpitaux, 20000 Casablanca, Maroc; Laboratoire de génétique et de pathologie moléculaire, faculté de médecine et de pharmacie de Casablanca, université Hassan 2, avenue Hasan II, BP 150, Mohammedia Casablanca, 20000 Casablanca, Maroc.
Service de neurologie, CHU Ibn Rochd, quartier des Hôpitaux, 20000 Casablanca, Maroc.
Rev Neurol (Paris). 2014 Aug-Sep;170(8-9):531-5. doi: 10.1016/j.neurol.2014.07.004. Epub 2014 Aug 28.
Multiple sclerosis (MS) is not uncommon in children. The aim of this study was to compare early onset MS (EOMS) with adult onset MS (AOMS).
A retrospective study including MS cases between 1997 and 2010. EOMS was defined by age at MS onset<18years. Data were collected using the EDMUS database (European Database of Multiple Sclerosis) including: sex, age at onset, disease duration, EDSS, score after relapse. The MSSS and the Progression Index were calculated. Patients with disease duration less than one year were excluded. MS symptoms at onset and at further relapses were also noted. These parameters were compared between the EOMS and the AOMS groups.
Two hundred fifty-nine cases were included including 31 EOMS (11.96%). The mean follow-up was 96months. The relapsing-remittent form was significantly more frequent in the pediatric group (94% vs 79%). Mean EDSS and MSSS scores and the percentage of fast progressors (MSSS>5) were lower in the EOMS group. Analysis of neurological symptoms at the first MS attack and further neurological events showed a lower frequency of gait disturbances, motor symptoms and bladder symptoms in the EOMS group compared with the AOMS group. The 10-year mean EDSS score was 1.9 for EOMS and 4.1 for AOMS, after 25years it was 4.5, and 7.27 respectively.
This study highlights the relative frequency of EOMS in our MS population. However, different severity scores showed less disability progression in EOMS patients compared with AOMS patient; irreversible disability was reached at an early age.
多发性硬化症（MS）在儿童中并不罕见。本研究的目的是比较早发型多发性硬化症（EOMS）和成人型多发性硬化症（AOMS）。
一项回顾性研究，纳入1997年至2010年间的MS病例。EOMS定义为MS发病年龄<18岁。使用EDMUS数据库（欧洲多发性硬化症数据库）收集数据，包括：性别、发病年龄、病程、扩展残疾状态量表（EDSS）、复发后评分。计算多发性硬化症严重程度评分（MSSS）和进展指数。病程少于一年的患者被排除。还记录了发病时和进一步复发时的MS症状。在EOMS组和AOMS组之间比较这些参数。
共纳入259例病例，其中31例为EOMS（11.96%）。平均随访时间为96个月。复发缓解型在儿童组中明显更常见（94%对79%）。EOMS组的平均EDSS和MSSS评分以及快速进展者（MSSS>5）的百分比更低。对首次MS发作时的神经症状和进一步的神经事件分析显示，与AOMS组相比，EOMS组步态障碍、运动症状和膀胱症状的发生率更低。EOMS组10年的平均EDSS评分为1.9，AOMS组为4.1；25年后分别为4.5和7.27。
本研究突出了EOMS在我们的MS人群中的相对频率。然而，不同的严重程度评分显示，与AOMS患者相比，EOMS患者的残疾进展较小；在早年就达到了不可逆的残疾。
