Published online by Cambridge University Press: 10 February 2021
Recognition and diagnosis of pediatric multiple sclerosis (MS) can be challenging given the broad differential of possible MS mimics and acquired demyelinating syndrome (ADS) phenotypes. It is not uncommon for clinicians to consider alternative diagnoses rather than MS in children with acute neurologic symptoms and white matter lesions on MRI, such as leukodystrophies, vasculopathies, mitochondrial defects, or other metabolic or inflammatory disorders. Once a diagnosis is made, the current lack of understanding regarding the safety and generalizability of use of disease-modifying therapy (DMT) in children can pose additional challenges to treating children and adolescents. In this chapter, we discuss the clinical presentation, diagnostic evaluation, and treatment approach to pediatric-onset MS, paying special attention to the areas in which pediatric disease may differ from adult-onset MS.
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