The authors present a patient with multiple sclerosis (MS) whose onset of illness was at 4 years of age. Three separate and distinct episodes of central nervous system (CNS) dysfunction associated with cerebrospinal fluid (CSF) pleocytosis, electroencephalographic (EEG) abnormalities, and extensive CNS white matter demyelination on both computerized tomography (CT) and magnetic resonance imaging (MRI) characterized her clinical course. Two episodes responded well to prednisone therapy.
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References
1.
Poser CM, Patz DW, Scheinberg L., et al. New diagnostic criteria for multiple sclerosis; guidelines for research proposals. Ann Neurol1983;13:227-31.
2.
Poser CMTaxonomy and diagnostic parameters in multiple sclerosis. Ann NY Acad Sci1984;436:233-45.
Ebers GCMultiple sclerosis and other demyelinating diseases. In: Asbury AK, McKhann GM, McDonald WI eds. Diseases of the nervous system . Philadelphia: W. B. Saunders, 1986:1268-81.
7.
Bye Ame, Kendall B., Wilson J.Multiple sclerosis in childhood: a new look. Dev Med Child Neurol1985;27:215-22.
8.
Gall JC, Hayles AB, Siekert RG, Keith HMMultiple sclerosis in childhood: A clinical study of 40 cases with onset in childhood. 1958; Pediatrics21:703-9.
9.
Low NL, Carter S.Multiple sclerosis in children. 1956; Pediatrics18:24-30.
10.
Hauser SL, Bresman MJ, Reinherz EL, Weiner HLChildhood multiple sclerosis: clinical features and demonstration of changes in T-cell subsets with disease activity. Ann Neurol1982;11:463-8.
11.
Parkin PJ, Hierons R., McDonald WIBilateral optic neuritis, a long-term follow-up. Brain1984;107:951-64.
12.
Kennedy C., Carter S.Relation of optic neuritis to multiple sclerosis in children. Pediatrics1961;28:377-87.
13.
Leigh RJ, Zee DSDiagnosis of peripheral ocular motor palsies and strabismus. In: Plum F, Baringer JR, Gilman S, eds. The Neurology of Eye Movement, (contemporary neurology series). Philadelphia: F. A. Davis, 1983:141-90.
14.
Gilman S., Bloedel JR, Lechtenberg R.The symptoms and signs of cerebellar disease. In: Plum F, Baringer JR, Gilman S, eds. Disorders of the Cerebellum (contemporary neurology series). Philadelphia: F. A. Davis, 1981:189-221.
15.
Herndon RM, Kasckow J.Electron microscopic studies of cerebrospinal fluid sediment in demyelinating disease. Ann Neurol1978;4:515-23.
16.
Johnson KP, Nelson BJMultiple sclerosis: diagnostic usefulness of cerebrospinal fluid. Ann Neurol1977;2:425-31.
17.
Kjaer M.Evoked potentials with special reference to the diagnostic value in multiple sclerosis. Acta Neurol Scand1983;67:67-89.
18.
Bartel DR, Markand ON, Kolar OJThe diagnosis and classification of multiple sclerosis: Evoked responses and spinal fluid electrophoresis. Neurology1983 ;33:611-7.
19.
Noseworthy JH , Paty DW, Ebers CGNeuroimaging in multiple sclerosis. In: Buonanno FS, guest ed. Neurologic clinics: symposium on neuroimaging. Vol. 2, number 4. Philadelphia, Pa.: W. B. Saunders , 1984(November):759-77.
20.
Hershey LA, Gado MH, Trotter JLComputerized tomography in the diagnostic evaluation of multiple sclerosis . Ann Neurol1979;5:32-9.
21.
Radue EW, Kendall BEIodine and xenon enhancement of computed tomography (CT) in multiple sclerosis (MS). Neuroradiology1978;15:153-8.
22.
Hanghton VM , Ho KC, Williams A., Elderik OKCT detection of demyelinated lesions in MS . AJR1979;132:213-5.
23.
Vinnela FV, Fox AJ, DeBrun GM, et al. New perspectives in computed tomography of multiple sclerosis . AJR1982;139:123-7.
24.
Kirshner HS , Tsai SI, Runge VM, et al. Magnetic resonance imaging and other techniques in the diagnosis of multiple sclerosis. Arch Neurol1985;42:859-63.
25.
Lukes SA, Crooks KE, Aminoff MJ, et al. Nuclear magnetic resonance imaging in multiple sclerosis. Ann Neurol1983;13:592-601.
26.
Ormerod I., McDonald WI, DuBoulay GH, et al. Disseminated lesions at presentation in patients with optic neuritis. J Neurol Neurosurg Psychiatry1986 ;49:124-7.
27.
McDonald WIThe significance of optic neuritis. Trans Ophthalmol Soc UK1983;103:230-46.
28.
Jackson JA, Leake DR, Schneider NJ, et al. Magnetic resonance imaging in multiple sclerosis: results in 32 cases. AJNR1985;6:171-6.
