Long-Term MRI Observations of Childhood-Onset Relapsing-Remitting Multiple Sclerosis

Cs Balássy; G. Bernert; C. Wöber-Bingöl; B. Csapó; B. Kornek; J. Széles; D. Fleischmann; D. Prayer

doi:10.1055/s-2001-12219

Neuropediatrics, Table of Contents

Neuropediatrics 2001; 32(1): 28-37
DOI: 10.1055/s-2001-12219

Original Article

Georg Thieme Verlag Stuttgart · New York

Long-Term MRI Observations of Childhood-Onset Relapsing-Remitting Multiple Sclerosis

Cs. Balássy^1,2 , G. Bernert³ , C. Wöber-Bingöl³ , B. Csapó⁴ , B. Kornek⁵ , J. Széles⁴ , D. Fleischmann¹ , D. Prayer^1,2

¹ Department of Radiology, University of Vienna, Vienna, Austria
² Division of Neuroradiology, University of Vienna, Vienna, Austria
³ Department of Pediatrics, University of Vienna, Vienna, Austria
⁴ Department of Surgery, University of Vienna, Vienna, Austria
⁵ Brain Research Institute, Division of Neuroimmunology, University of Vienna, Vienna, Austria

Abstract

Purpose: Long-term MRI follow-up of childhood-onset relapsing-remitting multiple sclerosis (RRMS) was carried out in 4 cases. MRI findings were correlated with clinical course and characteristic differences from adult-onset RRMS were elaborated. Methods: Two girls and one boy with true childhood-onset, and one girl with juvenile-onset RRMS underwent 5 - 16 MRI examinations within 6 - 8 years. The total number of lesions, the numbers of new, active, disappearing and reappearing lesions, infratentorial and U-fibre lesions, “giant” plaques and “black holes” were counted. Callosal atrophy and general brain atrophy were assessed. The findings were related to the physical status according to the Expanded Disability Status Scale (EDSS). Results and Conclusions: Results showed that the primary differences in childhood-onset RRMS compared to adult-onset RRMS lie in the lack of, or slower development of irreversible changes (“black hole” formation, brain atrophy). Despite callosal atrophy and intensive U-fibre region involvement, school performance was unchanged. Regarding the frequency of “giant” lesions, an even more pronounced white matter involvement was found in our children compared to adults. All children exhibited a rather “benign” disease course. A more intensive remyelination, less severe neuronal loss, and higher functional brain plasticity at younger ages may account for these differences.

Key words

Multiple sclerosis - MRI - Childhood-onset - Long-term follow-up

Full Text

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Dr. Csilla Balássy

Department of Radiology
University of Vienna

Währinger Gürtel 18 - 20

1090 Vienna

Austria

Email: csilla.balassy@rad.akh.magwien.gv.at