Presentation-Paediatric onset multiple sclerpsis

Diagnostic challenges in children A first demyelinating event may represent another acquired demyelinating syndrome Exclude both inflammatory / non-inflammatory mimics including NMOSD and MOGAD Cortical lesions, central vein sign, and optic nerve markers achieve a high accuracy in distinguishing RRMS from APQ4-NMOSD and MOGAD. Acute disseminated encephalomyelitis (ADEM) typically monophasic Some children can have recurrent clinical episodes or MRI evidence of new lesions AQP: aquaporin; MOGAD: myelin oligodendrocyte glycoprotein antibody disease; MRI: magnetic resonance imaging; NMOSD: neuromyelitis optica spectrum disorder; RRMS: relapsing-remitting MS Alroughani R, Boyko A. BMC Neurol. 2018 Mar 9;18(1):27. doi: 10.1186/s12883-018-1026-3 Cortese R, et al. Neurology. 2023 Jan 17;100(3):e308-e323