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  • Updated 02.07.2022
  • Released 10.17.2012
  • Expires For CME 02.07.2025

Pediatric multiple sclerosis

Introduction

Overview

Multiple sclerosis is a chronic autoimmune demyelinating disease affecting the central nervous system. Although rare in the pediatric population, its onset in the youth population is becomingly increasingly recognized. Because the developing nervous system is a particularly susceptible target of the immune system, children with multiple sclerosis represent a group in whom a strategy of induction of remission and maintenance of remission is likely to prevent long-term disability. The behavior of the immune system in children with multiple sclerosis appears to parallel that in children with other chronic inflammatory diseases. At the same time, the potential for enhanced neural plasticity in children provides a unique opportunity for functional recovery along with long-term disability prevention.

Key points

• Epidemiological data support the concept of the onset of multiple sclerosis as a parainfectious process.

• Development of chronic inflammation occurs in susceptible individuals on the basis of molecular characteristics of the individual’s immune system.

• The central nervous system provides targets that maintain the long-term immune response, some of which are unique to children.

• Age is an independent variable that, at least in part, determines the course of the disease in multiple sclerosis.

• Monitoring effective immune therapy is important in preventing long-term disability.

Historical note and terminology

The prevalence of pediatric multiple sclerosis has been considered to be low. However, the establishment of pediatric multiple sclerosis centers in the United States has led to an appreciation that pediatric multiple sclerosis represents an unmet need that is often under-diagnosed and undertreated.

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