Pediatric-onset Multiple Sclerosis: Comparative Study of Two Portuguese Cohorts in Two Different Periods (1975-2010 and 2011-2020)
DOI:
https://doi.org/10.46531/sinapse/AO/161/2026Keywords:
Age of Onset, Child, Multiple Sclerosis/diagnosis, Multiple Sclerosis/epidemiology, Multiple Sclerosis/therapyAbstract
Introduction: Pediatric-onset multiple sclerosis (POMS) has a distinct clinical course compared with adult MS. Specialized POMS clinics may be beneficial in disease management. We aimed to compare two cohorts with POMS followed before and after 2010, the year of establishment of our POMS outpatient clinic, to evaluate disease characteristics and treatment approaches.
Methods: A retrospective chart review of two POMS cohorts, followed between 1975-2010 [first cohort (FC)] and 2011-2020 [second cohort (SC)].
Results: A total of 45 patients with POMS were identified: 24 in the FC (58.3% female) and 21 in the SC (47.6% female). The most common presenting symptoms in the FC were hemiparesis (55.0%), brainstem symptoms (20.0%), and optic neuritis (15.0%), whereas optic neuritis (37.7%), brainstem symptoms (28.6%), and hypopesthesia (21.4%) predominated in the SC. The mean time to diagnosis was significantly shorter in the SC than in the FC. The median individual annualized relapse rate (ARR) was significantly higher in the SC [0.50 (0.29-1.33)] than in the FC [0.28 (0.15-0.44)] (p = 0.003), despite a substantially shorter median follow-up duration (3.0 vs 21.0 years). However, after adjustment for follow-up duration using the person-years method, the crude ARR was similar between cohorts. EDSS at the last follow-up was not significantly correlated with crude ARR in either cohort.
Conclusion: The diagnosis of POMS became prompter, probably reflecting improvements in recognition and knowledge of the disease in this subgroup. The crude ARR was not a predictor of disability in this POMS cohort.
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Copyright (c) 2026 Cláudia Monteiro, Cecília Martins, Ângela Seke, João Moura, Joana Martins, Raquel Samões, Ana Paula Sousa, Sónia Figueiroa, Ernestina Santos
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