Sunday, May 28, 2017

Pediatric MS pearls

1.  PPMS is very rare before age 18

2. associations include lots EBV, early menarche, obesity, HLA DR1*15

3. Kids with MS look genetically like adults with MS

4.  Kids can have lesion disappearance between attacks that can be confusing

5. Teens have lots of cortical lesions, atrophy, that corresponds with IQ

6.  ADEM kids also have atrophy especially thalamus

7.  Need to be 11 to accurately use McDonald criteria

8.  Incidence is 1:100,000

9. Consider differential diagnosis in  kids including ADEM,NMO, MOG, CRION (see separate post).  Well trained radiologists can be very helpful. In a series of 110 kids with demyelinating disease, 56 had MS,  25 had NMOSD, 12 had ADEM and 5 had RION

10.  RR is 2-3 times higher and disability rate is higher

11.  Don't diagnose with a presentation of encephalopathy

source- lectures at Consortium meeting session on pediatric MS 2017

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