Abstract:
BACKGROUND:The incidence of acquired demyelination of the CNS (acquired demyelinating syndromes [ADS]) in children is unknown. It is important that physicians recognize the features of ADS to facilitate care and to appreciate the future risk of multiple sclerosis (MS). OBJECTIVE:To determine the incidence, clinical features, familial autoimmune history, and acute management of Canadian children with ADS. METHODS:Incidence and case-specific data were obtained through the Canadian Pediatric Surveillance Program from April 1, 2004, to March 31, 2007. Before study initiation, a survey was sent to all pediatric health care providers to determine awareness of MS as a potential outcome of ADS in children. RESULTS:Two hundred nineteen children with ADS (mean age 10.5 years, range 0.66-18.0 years; female to male ratio 1.09:1) were reported. The most common presentations were optic neuritis (ON; n = 51, 23%), acute disseminated encephalomyelitis (ADEM; n = 49, 22%), and transverse myelitis (TM; n = 48, 22%). Children with ADEM were more likely to be younger than 10 years, whereas children with monolesional ADS (ON, TM, other) were more likely to be older than 10 years (p < 0.001). There were 73 incident cases per year, leading to an annual incidence of 0.9 per 100,000 Canadian children. A family history of MS was reported in 8%. Before study initiation, 65% of physicians indicated that they considered MS as a possible outcome of ADS in children. This increased to 74% in year 1, 81% in year 2, and 87% in year 3. CONCLUSION:The incidence of pediatric acquired demyelinating syndromes (ADS) is 0.9 per 100,000 Canadian children. ADS presentations are influenced by age.
journal_name
Neurologyjournal_title
Neurologyauthors
Banwell B,Kennedy J,Sadovnick D,Arnold DL,Magalhaes S,Wambera K,Connolly MB,Yager J,Mah JK,Shah N,Sebire G,Meaney B,Dilenge ME,Lortie A,Whiting S,Doja A,Levin S,MacDonald EA,Meek D,Wood E,Lowry N,Buckley D,Yimdoi
10.1212/01.wnl.0000339482.84392.bdsubject
Has Abstractpub_date
2009-01-20 00:00:00pages
232-9issue
3eissn
0028-3878issn
1526-632Xpii
72/3/232journal_volume
72pub_type
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