Clinical and MRI Characteristics of Multiple Sclerosis in Iranian Children and Adolescents Multiple sclerosis in the Iranian Children and Adolescents
Iranian Journal of Child Neurology,
Vol. 17 No. 1 (2023),
,
Page 91-98
https://doi.org/10.22037/ijcn.v17i1.37363
Abstract
Objective
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.
Results
Ninety-five patients including 64 female and 31 male subjects with mean age of 13.97±2.4 (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%).
Conclusion
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.
- Multiple sclerosis, natural history studies, epidemiology, childhood, adolescence
How to Cite
References
2. Renoux C, Vukusic S, Mikaeloff Y, Edan G, Clanet M, Dubois B, et al. Natural history of multiple sclerosis with childhood onset. N Engl J Med. 2007;356(25):2603-13. doi:10.1056/NEJMoa067597. [PubMed:17582070].
3. Ghezzi A, Deplano V, Faroni J, Grasso MG, Liguori M, Marrosu G, et al. Multiple sclerosis in childhood: clinical features of 149 cases. Mult Scler. 1997;3(1):43-6. doi:10.1177/135245859700300105. [PubMed:9160345].
4. Boiko A, Vorobeychik G, Paty D, Devonshire V, Sadovnick D. Early onset multiple sclerosis: a longitudinal study. Neurology. 2002;59(7):1006-10. doi:10.1212/wnl.59.7.1006. [PubMed:12370453].
5. Alroughani R, Boyko A. Pediatric multiple sclerosis: a review. BMC neurology. 2018;18(1):27-. doi:10.1186/s12883-018-1026-3. [PubMed:29523094].
6. Waldman A, Ness J, Pohl D, Simone IL, Anlar B, Amato MP, et al. Pediatric multiple sclerosis. Clinical features and outcome. 2016;87(9 Supplement 2):S74-S81. doi:10.1212/wnl.0000000000003028.
7. Gorman MP, Healy BC, Polgar-Turcsanyi M, Chitnis T. Increased relapse rate in pediatric-onset compared with adult-onset multiple sclerosis. Arch Neurol. 2009;66(1):54-9. doi:10.1001/archneurol.2008.505. [PubMed:19139299].
8. Benson LA, Healy BC, Gorman MP, Baruch NF, Gholipour T, Musallam A, et al. Elevated relapse rates in pediatric compared to adult MS persist for at least 6 years. Mult Scler Relat Disord. 2014;3(2):186-93. doi:10.1016/j.msard.2013.06.004. [PubMed:25878006].
9. Omrani F, Sahraian M, Saeen A, Omrani Z, Hayeri G. Early-onset multiple sclerosis: Reports of 300 patients from Iran. Journal of Pediatric Neurosciences. 2018;13(2):137-40. doi:10.4103/jpn.Jpn_122_17.
10. Etemadifar M, Nourian SM, Nourian N, Abtahi SH, Sayahi F, Saraf Z, et al. Early-Onset Multiple Sclerosis in Isfahan, Iran: Report of the Demographic and Clinical Features of 221 Patients. J Child Neurol. 2016;31(7):932-7. doi:10.1177/0883073816634853. [PubMed:26979097].
11. Etemadifar M, Abhari AP, Yadegarfar G, Salari M, Ghazavi M, Rayani M, et al. Epidemiological and clinical features of pediatric-onset multiple sclerosis: A population-based study in Isfahan, Iran, between 1997-2020. Tehran University of Medical Sciences; 2021.
12. Etemadifar M, Nasr-Esfahani AH, Khodabandehlou R, Maghzi AH. Childhood-onset multiple sclerosis: report of 82 patients from Isfahan, Iran. Arch Iran Med. 2007;10(2):152-6. [PubMed:17367215].
13. Nasehi MM, Nikkhah A, Moosazadeh M, Saket S, Alizadeh-Navaei R. Incidence of pediatric multiple sclerosis in Iran from 2000 to 2019. Iranian Journal of Child Neurology. 2021;16(1). doi:10.22037/ijcn.v16i1.35572.
14. Nasehi MM, Sahraian MA, Naser Moghadasi A, Ghofrani M, Ashtari F, Taghdiri MM, et al. Clinical and Epidemiological Aspects of Multiple Sclerosis in Children. Iran J Child Neurol. 2017;11(2):37-43. [PubMed:28698726].
15. Belman AL, Krupp LB, Olsen CS, Rose JW, Aaen G, Benson L, et al. Characteristics of Children and Adolescents With Multiple Sclerosis. Pediatrics. 2016;138(1). doi:10.1542/peds.2016-0120. [PubMed:27358474].
16. Boster AL, Endress CF, Hreha SA, Caon C, Perumal JS, Khan OA. Pediatric-onset multiple sclerosis in African-American black and European-origin white patients. Pediatr Neurol. 2009;40(1):31-3. doi:10.1016/j.pediatrneurol.2008.09.004. [PubMed:19068251].
17. Derle E, Kurne AT, Konuşkan B, Karabudak R, Anlar B. Unfavorable outcome of pediatric onset multiple sclerosis: Follow-up in the pediatric and adult neurology departments of one referral center, in Turkey. Multiple Sclerosis and Related Disorders. 2016;9:1-4. doi:https://doi.org/10.1016/j.msard.2016.06.002.
18. Langille MM, Islam T, Burnett M, Amezcua L. Clinical Characteristics of Pediatric-Onset and Adult-Onset Multiple Sclerosis in Hispanic Americans. J Child Neurol. 2016;31(8):1068-73. doi:10.1177/0883073816638754. [PubMed:27021143].
19. Alroughani R, Ahmed SF, Al-Hashel J. Pediatric-Onset Multiple Sclerosis Disease Progression in Kuwait: A Retrospective Analysis. Pediatr Neurol. 2015;53(6):508-12. doi:10.1016/j.pediatrneurol.2015.06.010. [PubMed:26383244].
20. Yamamoto E, Ginsberg M, Rensel M, Moodley M. Pediatric-Onset Multiple Sclerosis: A Single Center Study. Journal of Child Neurology. 2018;33(1):98-105. doi:10.1177/0883073817739789. [PubMed:29246096].
- Abstract Viewed: 82 times
- pdf Downloaded: 0 times