Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia.
Institute of Histology and Embryology "Aleksandar D. Kostić", Belgrade, Serbia.
PLoS One. 2020 Dec 2;15(12):e0243031. doi: 10.1371/journal.pone.0243031. eCollection 2020.
The present study represents one of the largest series of pediatric multiple sclerosis (PedMS) in Western Balkan region. This is the first study aimed to evaluate the characteristics of PedMS in the Serbian population.
This retrospective study on 54 PedMS, aged 7-17 years, was performed at the Clinic of Neurology and Psychiatry for Children and Youth in Belgrade, Serbia, a tertiary center for the diagnosis and treatment of children with neurological and psychiatric diseases.
Female to male ratio was 37 (68.5%): 17 (31.5%). Family history of MS was noted in 9.3% and autoimmune diseases in 24.1% patients. Co-occurring migraine was in 7,4%. Monofocal onset of disease was present in 77.8% patients. The most common initial symptoms were optic neuritis (37%), sensory disturbances (31.5%), motor deficit (24.1%), cerebellar (18.5%) and brainstem lesions (16.7%), pain (9.3%), acute disseminated encephalomyelitis like symptoms (1.9%), and hearing loss (3.7%). Visual evoked potentials were pathological in 75.9% of patients. Oligoclonal bands were positive in 68.5% of patients. Magnetic resonance imaging showed periventricular (94.4%), infratentorial (77.8%), juxtacortical and cortical changes (55.6%) and changes in the cervical spinal cord (33.3%). The median EDSS score was 2.0.
Our cohort significantly differs from the literature data regarding more frequent occurrence of optic neuritis, hearing loss as a first symptom, the relapsing-remitting course of the disease, higher proportion of early onset of disease, presence of co-occurring migraine and the frequent occurrence of epilepsy and other autoimmune diseases in the family.
本研究代表了西巴尔干地区最大的儿科多发性硬化症（PedMS）系列之一。这是第一项旨在评估塞尔维亚人群中 PedMS 特征的研究。
这项回顾性研究纳入了 54 名年龄在 7-17 岁的儿科多发性硬化症患者，他们在塞尔维亚贝尔格莱德的儿童和青少年神经病学和精神病学诊所接受治疗，该诊所是诊断和治疗儿童神经和精神疾病的三级中心。
男女比例为 37（68.5%）：17（31.5%）。9.3%的患者有 MS 家族史，24.1%的患者有自身免疫性疾病。7.4%的患者同时伴有偏头痛。77.8%的患者首发症状为单灶性。最常见的初始症状为视神经炎（37%）、感觉障碍（31.5%）、运动障碍（24.1%）、小脑（18.5%）和脑干病变（16.7%）、疼痛（9.3%）、急性播散性脑脊髓炎样症状（1.9%）和听力损失（3.7%）。75.9%的患者视觉诱发电位异常。68.5%的患者寡克隆带阳性。磁共振成像显示脑室周围（94.4%）、小脑下（77.8%）、皮质下和皮质改变（55.6%）和颈脊髓改变（33.3%）。中位 EDSS 评分为 2.0。
与文献数据相比，我们的队列在视神经炎更常见、听力损失为首发症状、疾病呈复发缓解病程、疾病早期发病比例更高、伴发偏头痛、癫痫和其他自身免疫性疾病家族史更常见等方面存在显著差异。
