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pediatric multiple sclerosis

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https://www.readbyqxmd.com/read/28895071/bringing-the-heet-the-argument-for-high-efficacy-early-treatment-for-pediatric-onset-multiple-sclerosis
#1
REVIEW
Marisa McGinley, Ian T Rossman
Pediatric-onset multiple sclerosis (POMS) is rarer than adult-onset disease, and represents a different diagnostic and treatment challenge to clinicians. We review POMS clinical and radiographic presentations, and explore important differences between POMS and adult-onset MS natural histories and long-term outcomes. Despite having more active disease, current treatment guidelines for patients with POMS endorse the off-label use of lower-efficacy disease-modifying therapies (DMTs) as first line. We review the available MS DMTs, their evidence for use in POMS, and the contrasting treatment strategies of high-efficacy early treatment and escalation therapy...
September 11, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28872902/maturational-trajectory-of-processing-speed-performance-in-pediatric-multiple-sclerosis
#2
Nadine Akbar, Alessio Signori, Maria Pia Amato, Maria Pia Sormani, Emilio Portaccio, Claudia Niccolai, Benedetta Goretti, Christine Till, Brenda Banwell
Processing speed is a frequently affected cognitive domain in pediatric multiple sclerosis (MS) and is commonly assessed using the Symbol Digit Modalities Test (SDMT). The objective of this study was to determine maturational trajectories in SDMT performance and baseline factors affecting trajectories in a sample of 82 pediatric MS individuals. Performance on the SDMT increased with age in patients with pediatric MS followed by a subsequent decline. Furthermore, patients who were older at disease onset and had a higher IQ showed greater gains with age, suggesting that these factors may be protective with respect to cognitive maturation in pediatric MS...
September 5, 2017: Developmental Neuropsychology
https://www.readbyqxmd.com/read/28843454/pediatric-multiple-sclerosis-genes-environment-and-a-comprehensive-therapeutic-approach
#3
REVIEW
Ryan Cappa, Liana Theroux, J Nicholas Brenton
BACKGROUND: Pediatric multiple sclerosis is an increasingly recognized and studied disorder that affects 3%-10% of all patients. The risk for pediatric multiple sclerosis is thought to be secondary to a complex interplay between environmental and genetic risk factors. MAIN FINDINGS: Environmental exposures, including sunlight (ultraviolet radiation, vitamin D levels), infections (Epstein-Barr virus), passive smoking, and obesity, have been identified as potential risk factors in youth...
July 13, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28831635/a-multicenter-observational-prospective-study-of-self-and-parent-reported-quality-of-life-in-adolescent-multiple-sclerosis-patients-self-administering-interferon-%C3%AE-1a-using-rebismart%C3%A2-the-future-study
#4
A Ghezzi, A Bianchi, D Baroncini, A Bertolotto, S Malucchi, V Bresciamorra, R Lanzillo, N Milani, V Martinelli, F Patti, C Chisari, M Rottoli, M Simone, D Paolicelli, A Visconti
Besides the impact of disease per se, the use of immunomodulatory therapies in adolescents with relapsing-remitting multiple sclerosis (RRMS) may have an effect on quality of life (QL). The FUTURE (Quality of liFe in adolescent sUbjecTs affected by mUltiple sclerosis treated with immunomodulatoRy agEnt using self-injecting device) study was designed to evaluate the changes in QL of Italian adolescents with RRMS receiving treatment with IFN-β1a (Rebif; 22 μg), administered subcutaneously three times weekly using the RebiSmart™ electronic autoinjection device over a 52-week period...
August 22, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28821687/mri-substrates-of-sustained-attention-system-and-cognitive-impairment-in-pediatric-ms-patients
#5
Ermelinda De Meo, Lucia Moiola, Angelo Ghezzi, Pierangelo Veggiotti, Ruggero Capra, Maria Pia Amato, Elisabetta Pagani, Agnese Fiorino, Lorena Pippolo, Maria C Pera, Giancarlo Comi, Andrea Falini, Massimo Filippi, Maria A Rocca
OBJECTIVE: To explore the structural and functional integrity of the sustained attention system in patients with pediatric multiple sclerosis (MS) and its effect on cognitive impairment. METHODS: We enrolled 57 patients with pediatric MS and 14 age- and sex-matched healthy controls (HCs). Patients with >3 abnormal tests at neuropsychological evaluation were classified as cognitively impaired (CI). Sustained attention system activity was studied with fMRI during the Conners Continuous Performance Test (CCPT)...
August 18, 2017: Neurology
https://www.readbyqxmd.com/read/28812249/long-term-disability-and-progression-in-spinal-onset-multiple-sclerosis
#6
Bedile Irem Tiftikcioglu, Irem Ilgezdi, Yasar Zorlu, Ufuk Sener, Figen Tokucoglu
The aim of this study is to investigate the long-term effects of the initial spinal cord (SC) involvement in MS patients. In this retrospective, single-center study, 824 patients with definite MS were screened. A total of 348 patients were excluded for ambiguous documentation of the initial relapse, pediatric onset, diagnosis of primary progressive disease, irregular assessments or visits causing doubt on the onset of progression time, and clinical follow-up duration less than 12 months. Eventually, 476 MS patients were included...
August 10, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28806345/pediatric-optic-neuritis-what-is-new
#7
Mark Borchert, Grant T Liu, Stacy Pineles, Amy T Waldman
Few diseases blur the margins between their childhood and adult-onset varieties as much as optic neuritis. This report will review our state of knowledge of pediatric optic neuritis, as well as its relationship to the latest consensus definitions of neuroinflammatory disease. Current diagnostic and treatment options will be explored, as well as our potential to uncover an understanding of pediatric optic neuritis through systematic prospective studies. The risk of evolving multiple sclerosis is probably less than in adults, but pediatric optic neuritis is more likely to be an initial manifestation of acute disseminated encephalomyelitis...
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28806189/the-use-of-optical-coherence-tomography-in-neuro-ophthalmology
#8
Noel C Y Chan, Carmen K M Chan
PURPOSE OF REVIEW: In the last decade, with the advances of optical coherence tomography (OCT) technology, different imaging protocols and analysis algorithms have been introduced to maximize the potential of this diagnostic tool in the evaluation of different eye diseases. This review aims to provide an update on these additional features, with respect to the management of a diverse range of neuro-ophthalmologic conditions. RECENT FINDINGS: Macular ganglion cell complex (mGCC) analysis has been shown to be superior to peripapillary retinal nerve fiber layer (pRNFL) analysis in certain settings, such as differentiating Leber's hereditary optic neuropathy from functional visual loss; monitoring neurodegenerative diseases or multiple sclerosis; and predicting visual loss in nonarteritic ischemic optic neuropathy...
August 12, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28796432/7t-mri-visualization-of-cortical-lesions-in-adolescents-and-young-adults-with-pediatric-onset-multiple-sclerosis
#9
Ritobrato Datta, Varun Sethi, Sophia Ly, Amy T Waldman, Sona Narula, Blake E Dewey, Pascal Sati, Daniel Reich, Brenda Banwell
BACKGROUND: Cortical pathology in multiple sclerosis (MS) has been associated with prolonged and progressive disease. 7T magnetic resonance imaging (MRI) provides enhanced visualization of cortical lesions (CLs). Hence, we conducted a pilot study to explore whether CLs occur early in MS, as evidenced by pediatric-onset patients. METHODS: A total of 8 pediatric-onset MS patients were imaged using 7T MRI. CLs were annotated on T1-weighted magnetization-prepared rapid acquisition of gradient echoes images as leukocortical (LC), intracortical, or subpial...
September 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28770374/mog-antibody-related-disorders-common-features-and-uncommon-presentations
#10
Álvaro Cobo-Calvo, Anne Ruiz, Hyacintha D'Indy, Anne-Lise Poulat, Maryline Carneiro, Nicolas Philippe, Françoise Durand-Dubief, Kumaran Deiva, Sandra Vukusic, Vincent Desportes, Romain Marignier
Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) have been reported in acute demyelinating encephalomyelitis (ADEM), optic neuritis (ON), and neuromyelitis optica spectrum disorders (NMOSD) in adults and pediatrics. We aimed to delineate the common features of MOG-Ab-related disorders in children and adults, and report uncommon presentations. Twenty-seven consecutive pediatric and adult patients testing positive for MOG-Ab, with a minimum follow-up of 6 months, were included. Comprehensive epidemiological, clinical, radiological, and laboratory data were retrospectively analyzed...
August 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28738749/an-update-on-multiple-sclerosis-in-children-diagnosis-therapies-and-prospects-for-the-future
#11
Eliza Gordon-Lipkin, Brenda Banwell
Multiple sclerosis (MS), a chronic demyelinating disease of the central nervous system, is increasingly being recognized in children and adolescents. Pediatric MS follows a relapsing-remitting course at onset, with a risk for early cognitive impairment. Areas covered: In this review, we discuss the clinical features of acute demyelinating syndromes in children and risk factors that increase the likelihood of a diagnosis of MS. We also address the application of diagnostic criteria for MS in children, immunological features, therapeutic options and psychosocial considerations for children and adolescents with MS...
October 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28695361/acute-disseminated-encephalomyelitis-prognostic-value-of-early-follow-up-brain-mri
#12
Diederik L H Koelman, David C Benkeser, Joshua P Klein, Farrah J Mateen
Patients with acute disseminated encephalomyelitis (ADEM) are presumed to have radiological monophasic disease, but this is uncertain since follow-up brain MRI is not routinely performed. We aimed to ascertain combined radiological and clinical monophasic disease in ADEM patients and to assess whether performing early (<6 months) follow-up brain MRI has prognostic value for subsequent multiphasic disease. We retrospectively studied the medical records of patients initially diagnosed with ADEM (years 2000-2014) at the Massachusetts General Hospital, USA...
August 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28694135/characteristics-of-pediatric-multiple-sclerosis-the-turkish-pediatric-multiple-sclerosis-database
#13
Ünsal Yılmaz, Banu Anlar, Kıvılcım Gücüyener
OBJECTIVE: To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey. METHODS: Data of MS patients with onset before age 18 years (n = 193) were collected from 27 pediatric neurology centers throughout Turkey. Earlier-onset (<12 years) and later-onset (≥12 years) groups were compared. RESULTS: There were 123 (63.7%) girls and 70 (36.3%) boys aged 4-17 years, median 14 years at disease onset. Family history of MS was 6...
June 29, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28675955/psychiatric-disorders-in-children-with-demyelinating-diseases-of-the-central-nervous-system
#14
Julia Pakpoor, Raph Goldacre, Klaus Schmierer, Gavin Giovannoni, Emmanuelle Waubant, Michael J Goldacre
INTRODUCTION: The profile of psychiatric disorders associated with multiple sclerosis (MS) may differ in children. We aimed to assess the risk of psychiatric disorders in children with MS and other demyelinating diseases, and vice versa. PATIENTS AND METHODS: We analyzed linked English Hospital Episode Statistics, and mortality data, 1999-2011. Cohorts were constructed of children admitted with MS and other central nervous system (CNS) demyelinating diseases. We searched for any subsequent episode of care with psychiatric disorders in these cohorts and compared to a reference cohort...
July 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28660405/xanthogranulomatous-osteomyelitis-of-the-humerus-in-a-pediatric-patient-with-alagille-syndrome-a-case-report-and-literature-review
#15
Adnan Cheema, Alexandre Arkader, Bruce Pawel
Xanthogranulomatous osteomyelitis (XO) is an exceedingly rare disease characterized by infiltration of histiocytes and foamy macrophages. Both on gross examination and on radiographs, XO can mimic malignancy. We describe the case of a 5-year-old female with Alagille syndrome who presented with a pathologic fracture of the right humerus. Initial radiographs revealed multiple osteolytic lesions in the distal humerus while MRI showed a large soft tissue mass. Biopsy confirmed the diagnosis of XO, which has hitherto not been described in a patient with Alagille syndrome...
June 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28641773/incidence-of-tonic-spasms-as-the-initial-presentation-of-pediatric-multiple-sclerosis-in-slovenia
#16
Neli Bizjak, Damjan Osredkar, Nuška Pečarič Meglič, Mirjana Perković Benedik
Tonic spasms (TS) are involuntary movement patterns that can present in patients with multiple sclerosis (MS). They have been first described decades ago, but are frequently missed and misdiagnosed, particularly in the pediatric MS patients and if appearing ahead of hallmark neurological signs and symptoms of MS. Slovenia is a country with the population of about 2 million people. In the years from 1992 to 2016, we have treated 57 sequential pediatric patients with MS at our hospital, which is the only tertiary medical institution for treating children with MS in the country...
July 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28637379/neuropsychological-outcomes-of-pediatric-demyelinating-diseases-a-review
#17
Alexander Tan, Cole Hague, Benjamin M Greenberg, Lana Harder
Immune-mediated central nervous system (CNS) demyelinating diseases impact various areas of the brain, optic nerves, and/or spinal cord and can result in a wide range of neurologic symptoms including adverse cognitive outcomes. Neuropsychological outcomes in adult multiple sclerosis (MS) are well documented, while literature on such outcomes in pediatric cohorts is more limited. Furthermore, literature on neuropsychological outcomes in pediatric acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), and transverse myelitis (TM) is even more limited...
June 21, 2017: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
https://www.readbyqxmd.com/read/28623545/analysis-of-genotypes-and-phenotypes-in-chinese-children-with-tuberous-sclerosis-complex
#18
Dayong Bai, Junyang Zhao, Li Li, Jun Gao, Xu Wang
Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome with serious clinical presentations, an autosomal dominant genetic disorder involving multiple organs and systems. We retrospectively investigated the clinical manifestations and genotypes of 20 Chinese children with TSC to enable informed diagnostic and surveillance recommendations in China. A retrospective analysis of clinical manifestations in 20 children (7.00±5.30 years old) with TSC was conducted. A genetic testing of the genes TSC1 and TSC2 was performed in 14 children...
June 14, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28608742/pediatric-onset-multiple-sclerosis-and-other-acquired-demyelinating-syndromes-of-the-central-nervous-system-in-denmark-during-1977-2015-a-nationwide-population-based-incidence-study
#19
Magnus Spangsberg Boesen, Melinda Magyari, Nils Koch-Henriksen, Lau Caspar Thygesen, Alfred Peter Born, Peter Vilhelm Uldall, Morten Blinkenberg
BACKGROUND: The incidence of acquired demyelinating syndromes (ADS) including multiple sclerosis (MS) has never been investigated in a Danish pediatric population. OBJECTIVES: We estimated the nationwide age- and sex-specific incidence of pediatric ADS including MS. METHODS: Data were sourced from the Danish Multiple Sclerosis Registry, providing cases of pediatric MS for 1977-2015, and the National Patient Register, providing cases of ADS during 2008-2015...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28608728/dietary-factors-and-pediatric-multiple-sclerosis-a-case-control-study
#20
Julia Pakpoor, Brandon Seminatore, Jennifer S Graves, Teri Schreiner, Amy T Waldman, Timothy E Lotze, Anita Belman, Benjamin M Greenberg, Bianca Weinstock-Guttman, Gregory Aaen, Jan-Mendelt Tillema, Jamie C McDonald, Janace Hart, Jayne M Ness, Yolanda Harris, Jennifer Rubin, Meghan Candee, Lauren Krupp, Mark Gorman, Leslie Benson, Moses Rodriguez, Tanuja Chitnis, Soe Mar, Ilana Kahn, John Rose, Suzan L Carmichael, Shelly Roalstad, Michael Waltz, T Charles Casper, Emmanuelle Waubant
BACKGROUND: The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease. OBJECTIVE: To determine the association between dietary factors and MS in children. METHODS: Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging)...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
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