Etemadifar Masoud, Nourian Sayed-Mohammadamin, Nourian Niloofaralsadat, Abtahi Seyed-Hossein, Sayahi Farnaz, Saraf Zahra, Fereidan-Esfahani Mahboobeh
Department of Neurology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Research Committee of Multiple Sclerosis (IRCOMS), Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Biological Science, California State University, Stanislaus, Turlock, CA, USA.
J Child Neurol. 2016 Jun;31(7):932-7. doi: 10.1177/0883073816634853. Epub 2016 Mar 15.
It is estimated that early-onset multiple sclerosis multiple sclerosis (early-onset multiple sclerosis) approximately incorporates 3-5% of the multiple sclerosis population. In this report on early-onset multiple sclerosis, the authors aimed to define demographic, clinical and imaging features in a case-series of true-childhood multiple sclerosis and to compare its characteristics with juvenile multiple sclerosis. The authors inspected the records of multiple sclerosis patients who were registered by Isfahan MS Society. Clinical and demographic data of children with less than 16 years of age were reviewed retrospectively. Out of 4536 multiple sclerosis patients referred to the authors' center, 221 patients (4.8%) had multiple sclerosis starting at the age of 16 or less (11 true-childhood multiple sclerosis vs 210 juvenile-onset multiple sclerosis); the female to male ratio was 4.81:1. In the mean follow-up period of 6.2 years, 22 patients (10.5%) had positive family history of multiple sclerosis, 196 (88.6%) patients were classified as relapsing-remitting multiple sclerosis, the mean (± SD Expanded Disability Status Scale) was 1.5 ± 1.1 at the last evaluation. The most common initial presentation was optic nerve involvement (36.1%) and cerebellar sign and symptoms (14.6%). In all, 13 patients (5.8%) had experienced seizure in the course of multiple sclerosis. This study indicated that early-onset multiple sclerosis is not rare condition and overwhelmingly affects girls even at prepubertal onset. Physicians should consider multiple sclerosis in suspicious pediatric cases.
据估计，早发型多发性硬化症（早发型多发性硬化症）约占多发性硬化症患者总数的3%-5%。在这份关于早发型多发性硬化症的报告中，作者旨在确定一系列真正儿童期多发性硬化症病例的人口统计学、临床和影像学特征，并将其特征与青少年型多发性硬化症进行比较。作者查阅了伊斯法罕多发性硬化症协会登记的多发性硬化症患者记录。回顾性分析了16岁及以下儿童的临床和人口统计学数据。在转诊至作者所在中心的4536例多发性硬化症患者中，221例（4.8%）在16岁及以下发病（11例为真正儿童期多发性硬化症，210例为青少年型多发性硬化症）；男女比例为4.81:1。在平均6.2年的随访期内，22例（10.5%）患者有多发性硬化症家族史阳性，196例（88.6%）患者被归类为复发缓解型多发性硬化症，最后一次评估时平均（±标准差扩展残疾状态量表）为1.5±1.1。最常见的首发表现是视神经受累（36.1%）和小脑体征及症状（14.6%）。总共有13例（5.8%）患者在多发性硬化症病程中发生过癫痫发作。这项研究表明，早发型多发性硬化症并非罕见疾病，即使在青春期前发病也绝大多数影响女孩。医生在可疑的儿科病例中应考虑到多发性硬化症。
