International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: Revisions to the 2007 definitions

Lourie Center for Pediatric MS. Stony Brook University Medical Center, USA.
Multiple Sclerosis (Impact Factor: 4.82). 09/2013; 19(10):1261-1267. DOI: 10.1177/1352458513484547


Background: There has been tremendous growth in research in pediatric multiple sclerosis (MS) and immune mediated central nervous system demyelinating disorders since operational definitions for these conditions were first proposed in 2007. Further, the International Pediatric Multiple Sclerosis Study Group (IPMSSG), which proposed the criteria, has expanded substantially in membership and in its international scope. Objective: The purpose of this review is to revise the 2007 definitions in order to incorporate advances in delineating the clinical and neuroradiologic features of these disorders. Methods: Through a consensus process, in which input was sought from the 150 members of the Study Group, criteria were drafted, revised and finalized. Final approval was sought through a web survey. Results: Revised criteria are proposed for pediatric acute disseminated encephalomyelitis, pediatric clinically isolated syndrome, pediatric neuromyelitis optica and pediatric MS. These criteria were approved by 93% or more of the 56 Study Group members who responded to the final survey. Conclusions: These definitions are proposed for clinical and research purposes. Their utility will depend on the outcomes of their application in prospective research.

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Available from: Silvia Tenembaum, Jan 04, 2014
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    • "This distinction is important as NMO responds to different immunomodulating agents than does MS. The spectrum of pediatric MS has also been the focus of extensive nosographic revision in recent years, and diagnostic criteria have been recently revised by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) [6]. "
    01/2014; 2014:812847. DOI:10.1155/2014/812847
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    • "In 2007, an international committee proposed provisional consensus definitions that included a range of clinical and laboratory findings to facilitate unification of criteria for accurate diagnosis and to encourage and promote clinical research in pediatric demyelinating disease [4]. The original definitions have been recently reviewed and updated [5]. "
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    ABSTRACT: Multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the central nervous system (CNS) commonly diagnosed in adults, is being recognized increasingly in children. An estimated 1.7%-5.6% of all patients with MS have clinical symptoms before reaching the age of 18 years. In comparison with adults, the diagnosis of MS in children can be more difficult, being dismissed or misdiagnosed as other clinical disorders. Although adults and children share basic aspects of the disorder, children have distinctive clinical features, neuroimaging, laboratory, and courses of the disease. The 2010 McDonald criteria have simplified the requirements for establishing the diagnosis of MS and have been proposed to be applicable for the diagnosis of pediatric MS, mainly in children 12 years and older. This paper describes the distinctive features of common pediatric demyelinating disorders, including MS, and summarizes the most recent advances based on the available literature.
    11/2013; 2013(3):673947. DOI:10.1155/2013/673947
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    ABSTRACT: Background Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that affects mainly young adults, but can occur also in children and adolescents. The pathogenesis of MS is still not fully understood and chronic cerebrospinal venous insufficiency (CCSVI) was suggested to be implicated in MS. Although there is no strong evidence to support this hypothesis, a considerable number of MS patients, including adolescents, have undergone endovascular treatment procedures. The aim of this study was the evaluate the prevalence of extracranial venous system anomalies in children and adolescents with multiple sclerosis in comparison to age-matched controls. Material and methods Twenty-one children with clinically definite diagnosis of MS (mean age 13.8 years), and 19 age-matched controls (mean age 12.5 years) were investigated using 1.5T scanner with coronal 3D contrast-enhanced coronal venography. The diameters of internal jugular veins (IJV) at both sides of the neck were estimated separately, from the level C1 to Th1. Results Anomalies of the extracranial venous system were found in 10 MS patients (47.6%) and 13 controls (68.4%). Normal anatomy of extracranial veins was recognized in 11 MS patients (53%) and 6 controls (31%). Comparison of the measurement results for MS patients and the control group revealed that there are no significant statistical differences in cross-section areas for a given level. Conclusions We found no evidence to suggest that MS children and adolescents have more extracranial veins anomalies than healthy patients. Considering the risk of such treatment, endovascular interventions should be discourage
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