In the past decade, the number of studies related to demyelinating diseases in children has exponentially increased. Demyelinating disease in children may be monophasic or chronic. Typical monophasic disorders in children are acute disseminated encephalomyelitis and clinically isolated syndromes, including optic neuritis and transverse myelitis. However, some cases of acute disseminated encephalomyelitis or clinically isolated syndrome progress to become chronic disorders, including multiple sclerosis and neuromyelitis optica. This review summarizes the current knowledge on monophasic and chronic demyelinating disorders in children, focusing on an approach to diagnosis and management.
Improved diagnostic definitions for pediatric demyelinating diseases have led to enhanced recognition of these disorders. Additionally, increased awareness and focused national and international efforts continue to inform about the clinical course, response to treatment, and disease pathogenesis.
Significant advances have been made in the recognition, diagnosis, and management of pediatric demyelinating disorders over the past 10 years. This review summarizes these advances and provides an updated approach to the diagnosis and management of pediatric demyelinating disorders.
Address correspondence to Dr Tanuja Chitnis, Massachusetts General Hospital, Department of Child Neurology, 75 Fruit St, ACC 708, Boston, MA 02114, firstname.lastname@example.org.
Relationship Disclosure: Dr Chitnis serves as a consultant for Biogen Idec, Novartis, and Teva Neuroscience, and receives research support from Merck Serono and grants from the National Multiple Sclerosis Society.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Chitnis discusses the unlabeled use of disease-modifying therapies for children with multiple sclerosis.