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Childhood MS.

Most cases of MS are diagnosed in people between the ages of 20 and 40. But diagnosis at older -- and much younger -- ages does occur. In fact, there is a report in the medical literature of a child whose initial symptoms appeared at 13 months and who was diagnosed at the age of 2.

Childhood MS has been recognized for over 100 years -- for example, Professor Pierre Marie, in France, reported 13 children with MS in 1883 -- but definite MS in children is very rare. Since the mid-1940s, some 25 medical publications have reported altogether about 400 cases of childhood MS, with 20 percent occurring before puberty. From a number of studies, it appears that fewer than 3 percent of these children had clinical symptoms before age 16.

The largest number of cases have occurred since 1980 -- but there is no evidence that childhood MS is becoming more common. Rather, increased knowledged and new technology, particularly the availability of magnetic resonance imaging (MRI), has helped physicians make definite diagnoses more readily. Added to that, pediatric neurologists are now more aware that MS is not always an adult-onset disease. Even so, a number of inborn metabolic disorders, structural abnormalities, and even brain tumors can produce symptoms typical of MS, and misdiagnosis or false diagnosis remains a problem.

Since childhood MS is so rare, it is difficult to generalize about how it compares with the adult-onset form of disease. Treatment is generally the same, although neurologists are concerned about the effects of steroids or experimental immunoregulatory agents on growth and development. Certain patterns do emerge from scientific studies.

* Symptoms in children tend to be similar to those in adults, with sensory problems seeming to be predominant.

* Nearly three times as many young girls as young boys are diagnosed. This compares with a ratio of about two women for each man diagnosed.

* Some reports indicate that mortality for children with MS is high: in one German study, as many as 10 percent of children diagnosed with MS died as a consequence of the disease within five years, of their diagnosis, compared to no adults during a similar time frame. The German researchers speculate that this may be a consequence of greater vulnerability in children's developing brains and immune systems. In general, thoug, the course of MS in children is reported to be somewhat slower than in adults.

* On the other hand, the vast majority of children with MS have relapsing-remitting disease and generally recover well from acute attacks. Do children have a greater potential for myelin regeneration than adults?

This and other import questions arise from the knowledge that MS can occur in children.
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Title Annotation:multiple sclerosis
Author:Reingold, Stephen
Publication:Inside MS
Date:Sep 22, 1993
Previous Article:Raising public awareness of MS.
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