[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-526652-105":59,"doc-detail-526652-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","Pediatric Multiple Sclerosis","","Pediatric onset multiple sclerosis (POMS) is diagnosed using a combination of clinical features, neuroimaging, blood tests, and sometimes cerebrospinal fluid studies because no single finding confirms the disease. The document summarizes IPMSSG 2007 pediatric criteria (updated in 2012) based on the 2010 McDonald criteria, then evaluates evidence for applying the 2017 McDonald updates in children. It reviews MRI roles, the diagnostic value of bloodwork and CSF to exclude mimics, and discusses current POMS disease-modifying therapies and active clinical trials.",{"@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/526652/",{"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/526652.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-11","2026-10-08",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What forms the basis of diagnosing pediatric onset multiple sclerosis (POMS)?","Question",{"text":112,"@type":113},"Diagnosis relies on characteristic clinical features, neuroimaging, blood tests, and at times cerebrospinal fluid analysis. There is no single finding that by itself secures the diagnosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do the IPMSSG 2012 criteria for POMS relate to the McDonald criteria?",{"text":117,"@type":113},"The IPMSSG pediatric criteria published in 2007 and updated in 2012 are based on the 2010 McDonald criteria and can be satisfied by any of four key criteria.",{"name":119,"@type":110,"acceptedAnswer":120},"Why might the 2017 McDonald criteria be used in children, and how valid are they?",{"text":121,"@type":113},"A prospective 2018 study evaluated applicability in a pediatric cohort and found that the 2017 McDonald criteria at the time of the incident demyelinating attack can be used with good validity. The reported sensitivity was 71% with specificity of 95%.","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},526652,1791621000,{"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":39,"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},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","| Pediatric Multiple Sclerosis\u003Cbr>Alexandra B. Kornbluh,* ,† and Ilana Kahn* ,† |  |\n| --- | --- |\n|  | |\n|  |  |\n| The current diagnostic criteria for pediatric onset multiple sclerosis (POMS) are summarized, as well as the evidence for performance of the most recent iteration of McDonald criteria in the pediatric population. Next, the varied roles of MRI in POMS are reviewed, including diagnostic considerations and research-based utilization. The primary role of bloodwork and cerebrospinal fluid studies in the diagnosis of POMS is to rule out disease mimics. Prognostically, POMS portends a more inflammatory course with higher relapse rate and disability reached at younger ages compared with AOMS counterparts. As such, there is an emerging trend toward the earlier use of highly efficacious disease modifying therapies to target prompt immunomodulatory disease control. Current POMS disease modifying therapies (DMTs) and active clinical POMS trials are detailed.\u003Cbr>Semin Pediatr Neurol 46:101054 © 2023 Elsevier Inc. All rights reserved. |  |\n\nDiagnosis  \nP ediatric onset multiple sclerosis (POMS), or multiple  \nsclerosis (MS) occurring in patients younger than 18 years of age, occurs in approximately 3%-10% of all cases of MS, and is being increasingly recognized in many world regions.1 ,2 Just as in adults, the diagnosis of POMS relies on a constellation of characteristic clinical features, neuroimaging, blood tests, and at times spinal fluid analysis, as there is no single finding that can secure the diagnosis. The diagnostic criteria for POMS were published by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) in 2007, and were most recently updated in 2012 .3 ,4 These diagnostic criteria are based on the 2010 McDonald criteria.5 Per the IPMSSG, a diagnosis of POMS can be satisfied by any of 4 key criteria (Table 1) .4  \nThough POMS definitions have not been updated since 2012, adult onset MS (AOMS) diagnostic criteria were revised in 2017 with updated McDonald Criteria (Tables 2 and 3) .6 The 2017 modifications included the addition that oligoclonal bands (OCBs) can be used to fulfill criteria for dissemination in time (DIT), thus helping to establish the diagnosis of MS after the first clinical event with a single brain MRI.6 The 2017 McDonald criteria also now allow inclusion of both symptomatic and asymptomatic MRI  \nFrom the *Children’s National Hospital, Washington, DC.  \nyGeorge Washington School of Medicine and Health Sciences, Washington, DC.  \nAddress reprint requests to Ilana Kahn, MD, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 . E-mail:  \n[ilkahn@childrensnational.org](ilkahn@childrensnational.org)  \nlesions in the determination of dissemination of space and time, and cortical lesions are considered equivalent to juxtacortical lesions. Overall, these changes have allowed MS tobe diagnosed more frequently at the time of first clinical event, thereby allowing more prompt initiation of treatment.7 To date there has not been updated POMS definitions toreflect the changes made for adult populations, but in practice the 2017 McDonald criteria are widely utilized in the care of pediatric patients.  \nA prospective 2018 study investigated whether the diagnostic criteria for adults were equally applicable in a pediatric cohort.8 Clinical imaging and laboratory features of 324 participants were examined, with median age about 10 years of age and a 6 years median length of follow-up. This study identified that the 2017 McDonald criteria applied at the time of incident demyelinating attack can be used with good validity to identify POMS.8 Predictors that help to differentiate features of MS compared with other causes of monophasic demyelination included the presence of at least 1 T1 hypodense lesion (black hole), gadolinium-enhancing lesion, and periventricular lesion.8 The absence of periventricular lesions was a strong predictor against the diagnosis of POMS.8 The overall sensitivity for the 2","cbCaisLyew3uwYbr","https://ap.wps.com/l/cbCaisLyew3uwYbr","pdf",614197,12,"English","# Diagnosis\n## Clinical features and diagnostic principles\n## IPMSSG criteria for POMS (2007, updated 2012)\n## Comparison with 2017 McDonald criteria in pediatric use\n## Predictors and diagnostic performance\n# Role of MRI and laboratory testing\n## MRI for dissemination in space and time\n## Bloodwork and cerebrospinal fluid studies","[{\"question\":\"What forms the basis of diagnosing pediatric onset multiple sclerosis (POMS)?\",\"answer\":\"Diagnosis relies on characteristic clinical features, neuroimaging, blood tests, and at times cerebrospinal fluid analysis. There is no single finding that by itself secures the diagnosis.\"},{\"question\":\"How do the IPMSSG 2012 criteria for POMS relate to the McDonald criteria?\",\"answer\":\"The IPMSSG pediatric criteria published in 2007 and updated in 2012 are based on the 2010 McDonald criteria and can be satisfied by any of four key criteria.\"},{\"question\":\"Why might the 2017 McDonald criteria be used in children, and how valid are they?\",\"answer\":\"A prospective 2018 study evaluated applicability in a pediatric cohort and found that the 2017 McDonald criteria at the time of the incident demyelinating attack can be used with good validity. The reported sensitivity was 71% with specificity of 95%.\"}]","Pediatric Multiple Sclerosis | PDF",1791499688]