MS is a chronic and generally remitting-relapsing disorder characterized by multiple white lesions in the CNS separated by time and location in the brain. The condition is rare in the pediatric population; 5% of all cases of MS occur before age 18 yrEtiology:
The cause of MS is unknown, but interactive genetic, immunologic, and infectious factors are probably responsible. A family history of MS in a first-degree relative is present in ?20%
Clinical Features:
The most frequent presenting signs are unilateral weakness with upper motor neuron signs, sensory abnormalities, visual complaints, or ataxia. Paresthesias involving the lower extremities, distal portions of the hands and feet, and the face are common.
Visual symptoms including diplopia, nystagmus, or sudden visual loss due to optic neuritis are also important early manifestations of MS.
Headache, fatigue, dysarthria, or myelopathy with a sensory level and neurogenic bladder can also be present, but impaired consciousness and encephalopathy are uncommon
Pathology:
The pathology of MS consists of demyelination with the formation of plaques
Diagnosis:
No reliable laboratory test unequivocally confirms the diagnosis of MS, except for a biopsy or an autopsy. MRI is the neuroimaging technique of choice; small plaques of 3–4 mm can be identified, particularly those located in the brainstem and spinal cord
A high percentage of pediatric patients have T2 enhancing lesions in the corpus callosum and periventricular white matter. The cerebrospinal fluid (CSF) often contains oligoclonal bands
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