Childhood multiple sclerosis: MR images and clinical variations in four Japanese cases.

We report four Japanese cases of multiple sclerosis (MS) starting during childhood. In three of them, onset occurred in the prepubertal period. Case 1 showed a rare clinical condition: the patient presented with Devic disease, and 2 years later she was complicated by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The other three cases had symptoms of gait disturbance, cerebellar signs, weakness of the extremities and impaired visual acuity. Headache was seen in Case 2 and medial longitudinal fasciculus (MLF) syndrome in Case 4. In Cases 2, 3 and 4, diagnoses were conclusively made by T2-weighted magnetic resonance imaging (MRI). MRI, brain stem auditory, visual and somatosensory evoked potentials are extremely useful for evaluating the clinical conditions of children with MS.