Relapse severity and recovery in early pediatric multiple sclerosis

Mult Scler. 2012 Jul;18(7):1008-12. doi: 10.1177/1352458511431725. Epub 2011 Dec 19.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain / pathology*
  • Child
  • Cohort Studies
  • Disease Progression
  • Female
  • Humans
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Optic Nerve / pathology*
  • Retrospective Studies
  • Severity of Illness Index