Relapse severity and recovery in early pediatric multiple sclerosis

Abstract

Background:

Factors determining severity and recovery of early demyelinating events in pediatric multiple sclerosis (MS) patients are unknown.

Objective:

The objective of this study was to characterize the severity and recovery of early demyelinating events in pediatric MS.

Methods:

Multivariate logistic regression was performed to determine predictors of severe (versus mild/moderate) relapses and poor or fair (versus complete) recovery in patients aged 18 years or less with MS or clinically isolated syndrome (CIS).

Results:

Optic nerve involvement (OR 4.30, 95% CI 1.50–12.3, p = 0.007) was associated with a severe initial demyelinating event (IDE), while non-White race (OR 2.55, 95% CI 0.87–7.49, p = 0.088), localization to the cerebral hemispheres (OR 7.94, 95% CI 0.86–73.8, p = 0.068), or encephalopathy (OR 8.70, 95% CI 0.86–88.0, p = 0.067) showed a trend towards increased IDE severity. A similar association with race was found for severe second events. A severe IDE (OR 6.90, 95% CI 2.47–19.3, p < 0.001) was associated with incomplete IDE recovery, with similar trends for second and third events. Incomplete recovery from the first event predicted incomplete second event recovery (OR 3.36, 95% CI 0.98–11.6, p = 0.055).

Conclusions:

These results may help identify children at risk for a more aggressive disease course.

Keywords

demyelinating disease epidemiology multiple sclerosis pediatric recovery severity

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