Tiralongo Giuseppe, Monte Gabriele, Ferilli Michela A N, Ursitti Fabiana, Sforza Giorgia, Ruscitto Claudia, Mazzeo Giuseppe, Borrelli Alessandro, Valeriani Massimiliano, Papetti Laura
Academy of Pediatrics, Tor Vergata University of Rome, 00133 Rome, Italy.
Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Children (Basel). 2025 Jul 22;12(8):963. doi: 10.3390/children12080963.
Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited.
The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden.
Headaches were reported by 78% of patients, predominantly migraines (68%), with a significantly higher prevalence in females (74%). No significant differences were found in age at MS onset or lesion load on brain MRI between patients with and without headaches. Among those with headaches, migraines represented a higher frequency of attacks and a greater need for prophylactic treatment compared to other headache types. Headache characteristics, including pain location and associated symptoms, showed no correlation with age at MS onset or lesion burden.
These findings indicate that while headaches are common in POMS and more frequent in females, their presence and features do not appear to directly influence the clinical or neuroradiological course of the disease. Further research with larger cohorts and longitudinal follow-up is warranted to better understand the underlying mechanisms and long-term impact of headaches in pediatric MS.
儿童期多发性硬化症（POMS）是一种罕见但通常更具侵袭性的多发性硬化症形式，与早期认知障碍相关，并对生活质量有重大影响。多发性硬化症和原发性头痛，尤其是偏头痛，在成人中已得到充分证实，但儿科人群的数据仍然有限。
这项回顾性研究的目的是检查64例POMS患者，分为有头痛和无头痛两组，以确定头痛的存在、POMS发病年龄和MRI病变负荷之间的潜在相关性。
78%的患者报告有头痛，主要是偏头痛（68%），女性患病率显著更高（74%）。有头痛和无头痛的患者在MS发病年龄或脑部MRI病变负荷方面未发现显著差异。在有头痛的患者中，与其他头痛类型相比，偏头痛发作频率更高，预防性治疗的需求更大。头痛特征，包括疼痛部位和相关症状，与MS发病年龄或病变负荷无关。
这些发现表明，虽然头痛在POMS中很常见，在女性中更频繁，但它们的存在和特征似乎并未直接影响疾病的临床或神经放射学进程。有必要进行更大规模队列和纵向随访的进一步研究，以更好地了解儿科MS中头痛的潜在机制和长期影响。
