Aspects of POMS compared with the adult form Relapsing remitting onset with high relapse rate (98%), rarely progressive onset Frequent brainstem/cerebellar involvement and acute polysymptomatic/ADEM-like onset Better remission after first clinical event The pattern of MRI has some peculiar aspects in pediatric MS MRI lesions more pronounced inflammatory pattern and enhanced capability to recover CSF oligoclonal bands are less frequent in POMS Early with cognitive and behavioral deficits Disability milestones are reached after a longer interval, but at a lower age compared to adults Ghezzi A, et al. Mult Scler Demyelinating Disord. 2, 5 (2017). https://doi.org/10.1186/s40893-017-0022-6 ; Renoux C, et al. N Engl J Med. 2007 Jun 21;356(25):2603-13; Gorman MP, et al. Arch Neurol. 2009 Jan;66(1):54-9; Amato MP, et al. Neurology. 2014 Oct 14;83(16):1432-8
ADEM: acute disseminated encephalomyelitis; MRI: magnetic resonance imaging; POMS: paediatric-onset multiple sclerosis
