Contributions
Abstract: 132
Type: Oral
In virtually all patients with childhood onset MS, the disease starts with relapses and remissions. The relapse rate is relatively higher than in adults, but in the early phase these patients recover good from these attacks. Over the years a secondary progressive course can be expected in the majority. Children with MS reach states of irreversible disability at a younger age, approximately 10 years earlier than adults with MS indicating that there is an endpoint in the plasticity of the CNS. Clinical symptoms of children with MS are generally comparable with adults. Still, cognitive dysfunction and fatigue may occur more frequent in children than in adults, although ageing and brain maturation may at least partially compensate this. Long term follow up data in children are scarce, but several clinical parameters have been identified that are associated with a more severe disease course, such as attack frequency, poor recovery from attacks and early brain stem attacks. It should be realized that current use is skewed to the use of the EDSS, a scale with limited value for follow up of these patients. MRI has a clear value in predicting a definite MS diagnosis in patients with a first attack of suspected MS, also termed acquired demyelinating syndrome (ADS), but its value as useful early clinical predictor for long term disease course remains to be determined. With the introduction of novel immunomodulatory drugs we are now able to influence the course of disease. Some environmental and genetic factors have been identified as disease modifiers of pediatric MS, but additional prospective research will be needed to find modifiable lifestyle factors that can improve the future life of children with this disease.
Disclosure: Served on advisory boards organised by Biogen Idec, Merck-Serono, Roche and Bayer-Schering. Participated in clinical trials sponsored by Biogen Idec, Merck-Serono, Roche, Sanofi Genzyme and Novartis.
Abstract: 132
Type: Oral
In virtually all patients with childhood onset MS, the disease starts with relapses and remissions. The relapse rate is relatively higher than in adults, but in the early phase these patients recover good from these attacks. Over the years a secondary progressive course can be expected in the majority. Children with MS reach states of irreversible disability at a younger age, approximately 10 years earlier than adults with MS indicating that there is an endpoint in the plasticity of the CNS. Clinical symptoms of children with MS are generally comparable with adults. Still, cognitive dysfunction and fatigue may occur more frequent in children than in adults, although ageing and brain maturation may at least partially compensate this. Long term follow up data in children are scarce, but several clinical parameters have been identified that are associated with a more severe disease course, such as attack frequency, poor recovery from attacks and early brain stem attacks. It should be realized that current use is skewed to the use of the EDSS, a scale with limited value for follow up of these patients. MRI has a clear value in predicting a definite MS diagnosis in patients with a first attack of suspected MS, also termed acquired demyelinating syndrome (ADS), but its value as useful early clinical predictor for long term disease course remains to be determined. With the introduction of novel immunomodulatory drugs we are now able to influence the course of disease. Some environmental and genetic factors have been identified as disease modifiers of pediatric MS, but additional prospective research will be needed to find modifiable lifestyle factors that can improve the future life of children with this disease.
Disclosure: Served on advisory boards organised by Biogen Idec, Merck-Serono, Roche and Bayer-Schering. Participated in clinical trials sponsored by Biogen Idec, Merck-Serono, Roche, Sanofi Genzyme and Novartis.