1 - Department of Neuroradiology, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisbon, Portugal
2 - Department of Pediatric Neurology, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisbon, Portugal
3 - Department of Neuroradiology, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisbon, Portugal
- XVII Congresso da SPNR, 25 e 26 de Novembro de 2022, Lisboa
Introduction: Multiple sclerosis (MS) typically arises between the ages 20-40, but its diagnosis has increased at earlier ages. Between 3-10% of MS cases present in pediatricage and <1% before 10 years-of-age. Diagnosis is challenging due to transient demyelinating events and other conditions with similar symptoms and imaging findings. Differences from the “classical” adult MS are described regarding epidemiology, symptoms, course, incapacity, and cognitive impairment. The imaging characteristics are also distinctive and the diagnosis criteria as well as the available therapies have some particularities.
Objectives and Methods: Clinical and imaging characterization of pediatric-onset MS (POMS) cases from Hospital Dona Estefânia. We retrospective analyzed the clinical-data and brain/spine MRI findings of our POMS data base from 2015 to 2020.
Results: We found 13 cases of POMS, 10 female. Onset-age ranges from 11-17 (mean 13,77), 2 patients 10 lesions in 10 patients (77%) and >20 lesions in 7 patients (54%). 77% had infratentorial lesions and 10 patients had at least one enhancing lesion. 5 patients (38%) had confluent lesions, 3 patients had thalamic involvement and all patients had spinal cord lesions.
Conclusions: POMS is infrequent, however growingly reported, which may suggest that was underdiagnosed in the past. This diagnosis is challenging due to the higher prevalence of transitory demyelinating events and other pathologies with similar symptoms and imaging findings. POMS has some particular clinical and imaging features that have been described in the literature and are present in the majority of our cases. Early identification is essential for a prompt therapy to modify the disease course.
Keywords: Multiple sclerosis; pediatric-onset multiple sclerosis; MRI