MULTIPLE SCLEROSIS IN A CHILD. CLINICAL CASE

Abstract

Introduction. Pediatric-onset multiple sclerosis (POMS) is defined as MS with onset before 18 years of age, using the 2017 McDonald Criteria. 3-5% of all MS cases have pediatric onset. Mean age of onset in POMS is 11 years, however, most patients are older than 15. There is a known female predilection for MS, although not in the younger than 11 years age group. Materials and methods. Our article presents a clinical case of MS in children. We think that this information will be interesting for neurologists and pediatricians. Results. Our patient is a boy 13 years, born from the 3 pregnancy, 3 birth. His development was appropriate for his age. There is no patient with multiple sclerosis in the offspring. Symptoms started with blurred vision in one eye when he was 11 years old. He was under the supervision of a neurologist and received treatment. His condition has stabilized. Symptoms repeated after 6 months. In addition to the weakness of vision, there is also a difficulty in performing precise movements. In neurological status: Pupils reaction to light was preserved. Left-sided oculomotor deficiency is noted. Swallowing and hearing N. In the motor sphere: peripheral muscle tone D=S, hypotonia, reflexes D=S, hyperreflexia, muscle strength D=S, normal. Reflexogenic zones in the lower limbs have expanded. Sensory system without any changes. He is unstable in the Romberg state. In finger- nose test intentional tremor is seen. Brain MRI: active demyelinating lesions (largest 14x8) in supratentorial and infratentorial region. Spine MRI: contrast enhancing demyelinating lesions in C1 and C5. 3 months later, an increase of demyelinating lesions was noted in the MRI examination of the brain and spinal cord. Ophthalmologist's examination: retrobulbar neuritis. LP: Oligoclonal band was positive. General and biochemical analysis of blood was normal. Conclusion. There is quite a lot of information about multiple sclerosis in adults in the literature. However, it has not been adequately studied in children. Thus, we believe that studying the characteristics of the course of multiple sclerosis in the pediatric population is important and of social importance.