Nasehi Mohammad Mahdi, Nikkhah Ali, Saket Sasan, Rezakhani Sepideh, Hosseini Mahya, Zahed Ghazal, Alizadeh Navaei Reza, Moosazadeh Mahmood
Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pediatric Neurology Department, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Child Neurol. 2023 Winter;17(1):91-98. doi: 10.22037/ijcn.v17i1.37363. Epub 2023 Jan 1.
To determine the clinical and MRI characteristics of multiple sclerosis (MS) in the children and adolescents.
MATERIAL & METHODS: In this cross-sectional study, information of 95 MS patients was obtained from the Iranian MS registry. Disease characteristics and imaging data were collected using medical records.
Ninety-five patients including 64 female and 31 male subjects with mean age of 13.97±2.4 years (range, 8-18) years were enrolled. The most frequent signs and symptoms were ophthalmic symptoms (n=61, 64.2%), brainstem signs (n=44, 46.3%), cerebellar signs (n=32, 33.6%) and pyramidal signs (n=26, 27.3%). Blurred vision (n=21, 34.4%) was the most common ophthalmic symptom and ataxia (n=24, 75%) the most prevalent cerebellar sign. The most common brainstem signs/symptoms were motor symptoms and vertigo (each n=14, 31.8%) and the most common pyramidal sign/symptom was right upper monoparesis (n=14, 23.3%). Active demyelinating lesions were reported in brain MRI of all patients, mostly appeared as periventricular (n=91, 95.8%) and pericallosal (n=55, 57.9%) lesions. Acute demyelinating spinal lesions were presented in 38 patients (51.3%) with a prominent involvement of the cervical spine (n=33, 86.8%).
In our study, the most frequent signs and symptoms were eye symptoms, brainstem signs, cerebellar signs and pyramidal signs, respectively. Moreover, our results showed that MRI plays a critical role in the diagnostic evaluation of MS in children with presence of brain lesions in all patients and spinal lesion in a considerable portion of patients.
确定儿童和青少年多发性硬化症（MS）的临床和MRI特征。
在这项横断面研究中，从伊朗MS登记处获取了95例MS患者的信息。使用病历收集疾病特征和影像数据。
纳入了95例患者，其中64例女性和31例男性，平均年龄为13.97±2.4岁（范围8 - 18岁）。最常见的体征和症状为眼部症状（n = 61，64.2%）、脑干体征（n = 44，46.3%）、小脑体征（n = 32，33.6%）和锥体束征（n = 26，27.3%）。视力模糊（n = 21，34.4%）是最常见的眼部症状，共济失调（n = 24，75%）是最常见的小脑体征。最常见的脑干体征/症状是运动症状和眩晕（各n = 14，31.8%），最常见的锥体束征/症状是右上肢单瘫（n = 14，23.3%）。所有患者的脑部MRI均显示有活动性脱髓鞘病变，主要表现为脑室周围（n = 91，95.8%）和胼胝体周围（n = 55，57.9%）病变。38例患者（51.3%）出现急性脱髓鞘性脊髓病变，其中颈椎受累明显（n = 33，86.8%）。
在我们这项研究中，最常见的体征和症状分别为眼部症状、脑干体征、小脑体征和锥体束征。此外，我们的结果表明，MRI在儿童MS的诊断评估中起着关键作用，所有患者均存在脑部病变，相当一部分患者存在脊髓病变。
