Paediatric multiple sclerosis: the experience of the German Centre for Multiple Sclerosis in Childhood and Adolescence

Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system and the most common disabling neurological disease in young adults. An estimated 5 % of MS patients already have first clinical symptoms before the age of 16 years (paediatric MS). In the paediatric age group comprehensive analysis of the natural clinical course and the course under treatment in a large MS cohort is still missing. We describe a cohort of paediatric MS patients treated in the German Centre for Multiple Sclerosis in Childhood and Adolescence. A total of 166 patients with definite MS who are registered in our database were analysed. The observation time was up to 14.9 years with a mean follow-up of 4.1 years. Median age was 12.4 years (range 4 to 18 years). Prior to puberty the gender ratio was almost equal, while in adolescence there was a strong female predominance as is seen in adult onset MS. Almost all patients presented with relapsing- remitting MS. The course of the disease was more benign than in adult MS with a very slow EDSS increase and complete remission after most relapses. Most patients received immunomodulative treatment with interferon-beta or glatiramer acetate and, in severe cases, natalizumab. However, adequate treatment guidelines for this age group are still lacking.