Relapse severity and recovery in early pediatric multiple sclerosis.

BACKGROUND

Factors determining severity and recovery of early demyelinating events in pediatric multiple sclerosis (MS) patients are unknown.

OBJECTIVE

The objective of this study was to characterize the severity and recovery of early demyelinating events in pediatric MS.

METHODS

Multivariate logistic regression was performed to determine predictors of severe (versus mild/moderate) relapses and poor or fair (versus complete) recovery in patients aged 18 years or less with MS or clinically isolated syndrome (CIS).

RESULTS

Optic nerve involvement (OR 4.30, 95% CI 1.50-12.3, p = 0.007) was associated with a severe initial demyelinating event (IDE), while non-White race (OR 2.55, 95% CI 0.87-7.49, p = 0.088), localization to the cerebral hemispheres (OR 7.94, 95% CI 0.86-73.8, p = 0.068), or encephalopathy (OR 8.70, 95% CI 0.86-88.0, p = 0.067) showed a trend towards increased IDE severity. A similar association with race was found for severe second events. A severe IDE (OR 6.90, 95% CI 2.47-19.3, p < 0.001) was associated with incomplete IDE recovery, with similar trends for second and third events. Incomplete recovery from the first event predicted incomplete second event recovery (OR 3.36, 95% CI 0.98-11.6, p = 0.055).

CONCLUSIONS

These results may help identify children at risk for a more aggressive disease course.