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 behavioural deficits

Disability milestones are reached after a longer interval, but at a lower age compared to adults

Ghezzi A, Baroncini D, Zaffaroni M,Comi G; Pediatric versus adult MS: similar or different?; Multiple Sclerosis and Demyelinating Disorders 2017; Renoux C, Vukusic S, Mikaeloff Y, et al. Natural history of multiple sclerosis with childhood onset. N Engl J Med. 2007; Gorman MP, Healy BC, Polgar-Turcsanyi M, et al.

Increased relapse rate in pediatric-onset compared with adult-onset multiple sclerosis. Arch Neurol.2009; Amato MP, Goretti B, Ghezzi A, et al.

Neuropsychological features in childhood and juvenile multiple sclerosis: five-year follow-up. Neurology.2014.