Multiple Sclerosis in Childhood: Single Center Experience/Cocukluk Caginda Multipl Skleroz: Tek Merkez Deneyimi

• Published in: Güncel pediatri Vol. 19; no. 2; p. 225
• Main Authors: Bodur, Muhittin, Toker, Rabia Tutuncu, Okan, Mehmet Sait
• Format: Journal Article
• Language: Turkish
• Published: Galenos Yayinevi Tic. Ltd 01.08.2021
• Subjects: Care and treatment; Diagnosis; Multiple sclerosis; Pediatric research; Risk factors; Turkey
• DOI: 10.4274/jcp.202L0028
• ISSN: 1304-9054

Introduction: In this study, clinical and demographic features of childhood multiple sclerosis(MS) diagnosed in a single center for 10 years are presented. Materials and Methods: In this study files of 23 patients with multiple sclerosis who were admitted to Department of Pediatric Neurology between January 2006 and January 2016 were investigated retrospectively. The data of 19 cases were evaluated since 3 cases were excluded due to lack of attending the control visits for more than 2 years and 1 case died in a traffic accident. Gender, current age, family history of MS, onset ages of symptoms, age at diagnosis, duration of disease follow-up, initial symptoms, magnetic resonance(MR) findings, cerebrospinal fluid(CSF) oligoclonal band positivity, visual evoked potential(VEP), somatosensory evoked potential(SEP) findings, treatments and a number of attacks were evaluated. Results: Of the 19 patients diagnosed with multiple sclerosis, 13 were female (68.4%), 6 were male (31.5%), and the female/male ratio was 2.16. The mean age of onset of symptoms was 14.09 years. The mean age of diagnosis was 15.2 years, and the mean follow-up period was 2.17 years. Family history was positive in 3 patients (15.7%). When the initial symptoms of our patients were examined, motor, sensory and brainstem findings were present in 11(57.8%), 9 (47.3%) and 7 cases (36.8%), respectively. Two patients (10.5%) presented with cerebellar findings and 6 patients (31.5%) with visual impairment. The oligoclonal band of CSF was found to be positive in 17 (89.4%) of the cases. Conclusions: In this study, gender, age, family history, age at onset of symptoms, initial symptoms, MR findings, CSF findings, VEP, SEP findings, treatments used, and the number of episodes were evaluated. Multicenter, prospective, and longitudinal studies with larger study populations are needed to understand multiple sclerosis onset in the pediatric period. Keywords Multiple sclerosis, childhood, treatment Giris: Bu calismada tek bir merkezde 10 yillik sure boyunca cocukluk cagi multipl skleroz (MS) tanisi alan olgularin klinik ve demografik ozellikleri sunulmustur. Gerec ve Yontem: Bu calisma cocuk noroloji poliklinigine Ocak 2006-2016 tarihleri arasinda basvuran ve multipl skleroz tanisi alan ve tedavi baslanan toplam 23 olgunun dosyalari restrospektif olarak degerlendirilerek yapilmistir. Bu olgulardan izlemde iki yildan uzun sure kontrollere gelmeyen uc olgu ve trafik kazasinda kaybedilen bir olgu disindaki 19 olgunun verileri degerlendirilmistir. Hastalarin cinsiyet, simdiki yas, aile oykusu, sikayetlerin baslangic yasi, tani yasi, hastalik izlem sureleri, baslangic semptomlari, manyetik rezonans (MR) bulgulari, beyin omurilik sivisi (BOS) oligoklonal bant pozitifligi, gorsel uyarilmis potansiyel (VEP) bulgulari, somatosensoriyel uyarilmis potansiyel (SEP) bulgulari, kullanilan tedavileri, atak sayilari acisindan degerlendirilmistir. Bulgular: Multipl skleroz tanisi alan ve tedavi baslanan 19 olgunun 13'u kiz(%68,4), 6'si erkek(%31,5) olarak saptanmistir, kiz/erkek orani 2,16 olarak saptanmistir. Olgularda semptomlarin baslangic yasi ortalama 14,09 yil olarak saptanmistir. Hastalarin ortalama tani yasi 15,2 yil, hastalarin cocuk noroloji polikliniginde median izlem suresi 2,17 yil olarak saptandi. Ailede multipl skleroz oykusu uc olguda (%15,7) pozitif olarak saptandi. Hastalarimizin baslangic semptomlarina bakildiginda 11 olgunun (%57,8) motor bulgularla, dokuz olgunun (%47,3) duyusal bulgularla, yedi olgunun (%36,8) beyin sapi bulgulari, iki olgunun (%10,5) serebellar bulgularla, alti olgunun (%31,5) gorme bozukluguyla ilk basvuru yaptiklari goruldu. BOS'ta bakilan oligoklonal bant olgularin 17'sinde (%89,4) pozitif olarak saptanmistir. Sonuc: Bu calismada klinigimizde, yakinmalari 18yas altinda baslayan ve cocukluk cagi MS tanisi alan olgularinin cinsiyet, yas, aile oykusu, sikayetlerin baslangic yasi, baslangic semptomlari, MR bulgulari, BOS bulgulari, VEP, SEP bulgulari, kullanilan tedavileri, atak sayilari acisindan degerlendirilmistir. Pediatrik donemde baslayan multipl sklerozu anlamak icin daha buyuk calisma populasyonlarini kapsayan, cok merkezli, prospektif ve longitudinal calismalara ihtiyac vardir. Anahtar kelimeler Multipl skleroz, cocukluk cagi, tedavi