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Multiple Sklerose (Enzephalomyelitis disseminata) des Kindes- und Jugendalters

Pediatric multiple sclerosis (encephalomyelitis disseminata)

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Zusammenfassung

Die Multiple Sklerose (MS) ist eine chronisch-entzündliche, demyelinisierende Erkrankung des zentralen Nervensystems ungeklärter Genese. Sie betrifft überwiegend junge Erwachsene, aber in 3–5% der Fälle auch Kinder und Jugendliche vor dem 16. Geburtstag. Häufige Symptome bei Kindern sind visuelle Störungen, Sensibilitätsausfälle und motorisch-koordinative Symptome. Der Krankheitsverlauf ist meist schubförmig-remittierend, häufig mit Komplettremission, in seltenen Fällen auch primär chronisch progredient. Typische paraklinische Befunde sind Läsionen der weißen Hirnsubstanz, oligoklonale Banden im Liquor und verzögerte evozierte Potenziale. Die akuten Schübe können mit Methylprednisolonstößen behandelt werden. Als Langzeitbehandlung kommen schubprophylaktische, immunmodulatorische Therapien zur Anwendung.

Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system of unknown etiology normally affecting young adults. Approximately 3–5% of MS patients have onset before the age of 16 (pediatric MS). Neurological deficiencies can occur in multifocal localisations. McDonald’s criteria include the dissemination in space and time of the disease activity. Symptoms include, for example, visual dysfunction and sensory or motor impairments. The most frequent clinical manifestation in the pediatric group is a relapsing-remitting disease course, with a milder course of disease and a lower rate of progression when compared to adult MS. Typical diagnostic findings are periventricular lesions of the white matter, oligoclonal bands in the cerebrospinal fluid and delayed evoked potentials. Relapses are treated with high-dose methylprednisolone. Prophylactic, immunomodulative therapies as suggested for adult MS patients are also used for children.

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Stark, W., Gärtner, J. Multiple Sklerose (Enzephalomyelitis disseminata) des Kindes- und Jugendalters. Monatsschr Kinderheilkd 157, 67–80 (2009). https://doi.org/10.1007/s00112-008-1915-4

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