1. Therapeutic Area
  2. Site Demo
  3. mspatients

mspatients

 
Rob
 

Sofia

 

Ana

 
Patient Stories
Rob, aged 14 years
Not an actual

patient with MS
School level: Secondary

Hobbies: Horseback riding, football, gaming
Initial Presentation

Physical
  • Dizziness, clumsy gait, reduced sensation in legs; now struggling in favorite sports



Cognitive

  • Difficulty finishing school lessons, trouble concentrating, fatigue



Emotional

  • Anxiety, uncooperative in school, exhibiting inappropriate behaviors, directing anger at parents and siblings

 

+
  Test Results:
     
  • Impaired sensation below T8-T9
     
  • Below-average scores on Brief Repeatable Battery of Neuropsychological Tests (BRB-N) in executive function, processing speed, and word retrieval

Sofia, aged 12 years
Not an actual

patient with MS
School level: Secondary

Hobbies: Swimming, coding
Initial Presentation

Physical
  • Blurred vision, pain with eye movement



Emotional

  • Withdrawn, sad

 

+
  Test Results:
     
  • Increased latencies and reduced amplitudes of wave forms on visual evoked potentials (VEP) test
     
  • Oligoclonal banding proteins in the CSF following lumbar puncture
     
  • Brain MRI exhibits multiple T2 lesions in the cerebral white matter
Ana, aged 16 years
Not an actual

patient with MS
School level: Secondary

Hobbies: Drama, reading
Initial Presentation

Physical
  • Tingling sensation in legs, fatigue, bladder control problems



Cognitive

  • Slurred speech, trouble concentrating



Emotional

  • Withdrawn, sad

 

+
  Test Results:
     
  • Slightly elevated CSF proteins and CSF glucose following lumbar puncture
     
  • Spinal MRI exhibits 2 T2 lesions
     
  • Brain MRI exhibits multiple T2 lesions in the cerebral white matter
Follow the clues in your pediactric patients with this downloadable questionnaire about MS symptoms
Identifying MS early can make all the difference. Partner with a multidisciplinary care team, including a neurologist or pediatric neurologist, upon early suspicion of MS in your young patients. 

 

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References:
 
1. Chitnis T, Glanz B, Jaffin S, Healy B. Demographics of pediatric-onset multiple sclerosis in an MS center population from the Northeastern United States. Mult Scler. 2009;15(5):627-631. 2. National Multiple Sclerosis Society. https://www.nationalmssociety.org/. Published August 27, 2018. Accessed April 19, 2019. 3. Belman AL, Krupp LB, Olsen CS, et al. Characteristics of children and adolescents with multiple sclerosis. Pediatrics. 2016;138(1):e20160120. 4. Ghezzi A, Baroncini D, Zaffaroni M, Comi G. Pediatric versus adult MS: similar or different? Mult Scler Demyelinating Disord. Published online May 7, 2017. doi:10.1186/s40893-017-0022-6. 5. Renoux C, Vukusic S, Mikaeloff Y, et al. Natural history of multiple sclerosis with childhood onset. N Engl J Med. 2007;356(25):2603-2613. 6. Pena JA, Lotze TE. Pediatric multiple sclerosis: current concepts and consensus definitions. Autoimmune Dis. 2013;2013:673947. 7. Alroughani R, Boyko A. Pediatric multiple sclerosis: a review. BMC Neurol. 2018;18(1):27. doi:10.1186/s12883-018-1026-3. 8. Lulu S, Graves J, Waubant E. Menarche increases relapse risk in pediatric multiple sclerosis. Mult Scler. 2016;22(2):193-200. 9. Chabas D, Green AJ, Waubant E. Pediatric multiple sclerosis. NeuroRx. 2006;3(2):264-275. 10. Venkateswaran S, Banwell B. Pediatric multiple sclerosis. Neurologist. 2010;16(2):92-105. 11. Mellen Center Approach: Pediatric Onset Multiple Sclerosis. Cleveland Clinic. https://my.clevelandclinic.org/-/scassets/files/org/neurological/multipl.... Accessed April 19, 2019. 12. Ghezzi A. Pediatric multiple sclerosis: epidemiology, clinical aspects, diagnosis and treatment. Neurodegener Dis Manag. 2017;7(6s):23-25. 13. Pediatric Multiple Sclerosis. Cleveland Clinic. https://my.clevelandclinic.org/ccf/media/files/Multiple_sclerosis_center.... Accessed April 19, 2019. 14. Jancic J, Nikolic B, Ivancevic N, et al. Multiple sclerosis in pediatrics: current concepts and treatment options. Neurol Ther. 2016;5(2):131-143. 15. Chitnis T, Arnold DL, Banwell B, et al. Trial of fingolimod versus interferon beta-1a in pediatric multiple sclerosis. N Engl J Med. 2018;379(11):1017-1027. 16. Amato MP, Krupp LB, Charvet LE, et al. Pediatric multiple sclerosis: cognition and mood. Neurology. 2016;87(suppl 2):S82-S87. 17. Waldman A, Ness J, Pohl D, Chitnis T. Pediatric multiple sclerosis: clinical features and outcome. Neurology. 2016;87(9 suppl 2):S74-S81. 18. Gorman MP, Healy BC, Polgar-Turcsanyi M, Chitnis T. Increased relapse rate in pediatric-onset compared with adult-onset multiple sclerosis. Arch Neurol. 2009;66(1):54-59. 19. Harding KE, Liang K, Cossburn MD, et al. Long-term outcome of paediatric-onset multiple sclerosis: a population-based study. J Neurol Neurosurg Psychiatry. 2013;84(2):141-147. 20. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-1452. 21. Aubert-Broche B, Fonov V, Narayanan S, et al. Onset of multiple sclerosis before adulthood leads to failure of age-expected brain growth. Neurology. 2014;83(23):2140-2146. 22. Kerbrat A, Aubert-Broche B, Fonov V, et al. Reduced head and brain size for age and disproportionately smaller thalami in child-onset MS. Neurology. 2012;78(3):194-201. 23. Nobis K, Bartels F, Anlar B, et al. Pediatric multiple sclerosis is associated with brain growth failure. Neuropediatrics. 2006;47. doi: 10.1055/s-0036-1583721. 24. MacAllister WS, Boyd JR, Holland NJ, et al. Neurology. 2007;68(16 suppl 2):S66-69. 25. Banwell B, Bar-Or A, Giovannoni G, Dale RC, Tardieu M. Therapies for multiple sclerosis: considerations in the pediatric patient. Nat Rev Neurol. 2011;7(2):109-122.



 

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