[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-618524-105":59,"doc-detail-618524-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","pediatric-multiple-sclerosis-618524","Pediatric Multiple Sclerosis","","Pediatric multiple sclerosis (MS) onset during childhood is relatively uncommon, yet its exact incidence remains uncertain. Distinguishing early pediatric MS from acute disseminated encephalomyelitis is challenging, especially in very young children, contributing to underrecognition. Risk may be influenced by prior Epstein-Barr virus infection, cigarette smoke exposure, and HLA-DRB1*15. Children more often show posterior fossa involvement and higher relapse rates, with earlier onset of disability. Off-label adult disease-modifying therapies are used, but efficacy and safety data for children are limited.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pediatric-multiple-sclerosis-618524/618524/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pediatric-multiple-sclerosis-618524/618524.png","ImageObject",300,407,{"name":92,"@type":93},"Jasmine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-10-19",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is the incidence of pediatric multiple sclerosis difficult to determine?","Question",{"text":112,"@type":113},"Published population-based incidence data remain limited, and estimation can be biased by underrecognition when children cannot clearly describe mild neurologic symptoms. In addition, some studies are not population-based and may have recall bias.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What factors are associated with increased risk of pediatric multiple sclerosis?",{"text":117,"@type":113},"Reported environmental and genetic contributors include prior Epstein-Barr virus infection, exposure to cigarette smoke, and the HLA-DRB1*15 haplotype.",{"name":119,"@type":110,"acceptedAnswer":120},"How do clinicians diagnose pediatric multiple sclerosis and what challenges exist?",{"text":121,"@type":113},"Diagnosis requires two or more episodes of demyelination. After the first clinical attack, dissemination in space and time on brain MRI helps, but distinguishing pediatric MS from conditions such as acute disseminated encephalomyelitis can delay diagnosis, especially in young children.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},618524,1792633372,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41,"preview_page_count":4},2336478487870,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","PEDIATRIC MULTIPLE SCLEROSIS  \nEllen M. Mowry, Emmanuelle Waubant  \nABSTRACT  \nMultiple sclerosis (MS) onset in childhood occurs in a small proportion of individuals with the disease, although the precise incidence of pediatric MS is unknown. It maybe difficult to distinguish the initial attack of pediatric MS from acute disseminated encephalomyelitis, particularly in very young children. Environmental and genetic factors that appear to increase the risk of pediatric MS include prior infection with Epstein-Barr virus, exposure to cigarette smoke, and HLA-DRB1*15 haplotype. Children may have more posterior fossa involvement at onset and a higher relapse rate than adults with MS. Although time to disability may be longer than in adults, pediatric MS is associated with an earlier age of disability. Off-label use of standard disease-modifying therapies for adult MS is common, although data regarding the efficacy and safety for these medications are limited.  \nContinuum Lifelong Learning Neurol 2010;16(5):181–192 .  \nINTRODUCTION  \nWhile pediatric multiple sclerosis (MS) was reported as early asthe late mid-19th century, it is only in the past 2 decades that there has been a growing interest in refining the definition of pediatric MS and better characterizing its management. Because the disease onset forchildren is likely closer to the time of exposure to susceptibility factors than for adults, pediatric MS may provide important insights about the etiology and pathogenesis of the disorder.  \nINCIDENCE AND PREVALENCE  \nIn a 1987 population-based study, 2.7% of patients with MS had symptom onset before the age of 16 years.1 More recent studies have reported that up to 4.4% of patients had onset before 16 or 18 years of age, although these studies are not  \npopulation-based and may also have been subject to recall bias.2 The only published population-based incidence study incorporated several acquired demyelinating disorders and did not specifically report the incidence of pediatric MS; as such, the precise incidence remains unknown.3 It is unclear whether MS in children has increased in parallel with the increased incidence in adults during the past 50 years.4  \nChallenges particular to the pediatric population may lead to bias in estimating the incidence or prevalence of MS.  \n(1) A child may not be able to clearly describe abnormal neurologic symptoms, particularly if they are mild orthe child is young, leading to underrecognition of the disease. (2) In part because of the paucity of literature dedicated to pediatric MS, the first attack of MS is often attributed to a monophasic  \nRelationship Disclosure: Dr Mowry is supported by a National Multiple Sclerosis Society Sylvia Lawry Fellowship Award. Dr Waubant has received research support from Biogen Idec, Genentech Inc. , Pfizer Inc, Sanofi-Aventis, the National Multiple Sclerosis Society, and the Nancy Davis Foundation.  \nUnlabeled Use of Products/Investigational Use Disclosure: Drs Mowry and Waubant discuss the unlabeled use of interferon beta-1a, interferon beta-1b, and glatiramer acetate for the treatment of pediatric multiple sclerosis.  \nKEY POINT A While it is  \nthought that multiple sclerosis (MS) onset in childhood occurs in a small percentage of patients with the disease, unique characteristics of children may lead to underdiagnosis of the disease in this population.  \n181  \nCopyright \\# 2010, American Academy of Neurology. All rights reserved.  \nCopyright @ American Academy of Neurology. Unauthorized reproduction of this article is prohibited.  \n \"PEDIATRIC MULTIPLE SCLEROSIS  \n182  \nTABLE 10-1  Limited Differential  \nDiagnosis of Pediatric Multiple Sclerosis  \n\" Monophasic Demyelinating Disorders  \nAcute disseminated  \nencephalomyelitis\" Inflammatory Disorders  \nBehet disease Neuromyelitis optica Neurosarcoidosis Scleroderma en coup de sabre  \nSjgren disease  \nSystemic lupus  \nerythematosus\" Infectious Disorders  \nHerpes simplex virus HIV  \nHuman T-cell lymphotrophic vi","cbCaimKVDYmbgLK7","https://ap.wps.com/l/cbCaimKVDYmbgLK7","pdf",1031286,12,"English","# Abstract\n# Introduction\n# Incidence and Prevalence\n# Diagnosis","[{\"question\":\"Why is the incidence of pediatric multiple sclerosis difficult to determine?\",\"answer\":\"Published population-based incidence data remain limited, and estimation can be biased by underrecognition when children cannot clearly describe mild neurologic symptoms. In addition, some studies are not population-based and may have recall bias.\"},{\"question\":\"What factors are associated with increased risk of pediatric multiple sclerosis?\",\"answer\":\"Reported environmental and genetic contributors include prior Epstein-Barr virus infection, exposure to cigarette smoke, and the HLA-DRB1*15 haplotype.\"},{\"question\":\"How do clinicians diagnose pediatric multiple sclerosis and what challenges exist?\",\"answer\":\"Diagnosis requires two or more episodes of demyelination. After the first clinical attack, dissemination in space and time on brain MRI helps, but distinguishing pediatric MS from conditions such as acute disseminated encephalomyelitis can delay diagnosis, especially in young children.\"}]","Pediatric Multiple Sclerosis | PDF",1792448859]