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MS in Children Versus Adults

March 6, 2017

So children, of course, are unique and children differ from adults in many ways. Importantly, the course of pediatric MS is very inflammatory and we do know that children experience about two to three times as many relapses as a typical adult onset MS patient. This may be due to the differences in the immune system of children or maybe other factors that we're not aware of. However, it does pose important questions around treatment and probably very potent anti-inflammatory treatments would be beneficial in this population balanced with safety.

A second piece of information that's important to be aware of is that cognitive measures or cognitive impairment may be quite prevalent in pediatric multiple sclerosis patients. We know that at least one-third of children will have significant impairment on at least two cognitive tests and about two-thirds or 60% of children will have some impairment on at least one test. This is an important area for clinicians to be aware of and to address, both clinically as well as in clinical trial studies. This needs to be studied.

A third area, and this is some good news, is that children may recover better from relapses than the typical adult onset MS patient. This is both good news because it does lead to lower disability rates, however, it is an area of concern since children are having frequent relapses and recovery over time may not be as good.

A fourth area to be aware of is that children have improved outcomes on what's called ambulatory or locomotor disability scales like the EDSS, and this may be due to possibly lower lesion load in the spinal cord or just better recovery from relapses in general, so this is another area that we are investigating and trying to understand the basis for.


Via MedPage Today