1,721,068 research outputs found
Pediatric multiple sclerosis - A short history of a long story
No full textShortly after multiple sclerosis ( MS) was described by Charcot in 1872-1873, symptoms of MS were noted in children. At the time of these observations ( late 19th century), the many inherited demyelinating diseases that manifest during childhood had not yet been recognized. Once the inherited demyelinating disorders became known, MS as a childhood disease was dismissed as a possible diagnosis. Only a half century later, with increased understanding of both inherited leukodystrophies as well as MS, was it acknowledged that children can develop MS. Our present challenges in the differential diagnoses of demyelinating disorders presenting in childhood are reflected in the history of pediatric MS
Single voxel proton MR spectroscopy methods and applications in neuropediatrics
No full textThe purpose of this contribution is to introduce quantitative single voxel proton MR spectroscopy of the human bl-ain as an easy-to-use method for a noninvasive assessment of cellular composition and metabolism and to demonstrate its clinical potential in the field of neuropediatrics. The chosen approach transforms fully relaxed (TR = 6000 ms) short echo time (TE = 20 ms) proton MR spectra (STEAM localization sequence) into absolute metabolite concentrations by automatically fitting the raw data with a library of model spectra comprising all metabolites at known concentration (L-CModel), The procedure includes total N-acetylaspartyl compounds as a marker for viable neuroaxonal tissue and myo-inositol as a purely glial constituent as well as total creatine, choline-containing compounds, glutamate and glutamine, and lactate. Extensive studies of brain disorders in childhood suggest the use of proton MRS as a promising tool for an in vivo histopathologic characterization of brain tissue. Typical metabolite patterns are observed for pathologic processes such as lactic acidosis, loss of functioning neurons, astrocytosis, myelin breakdown, or loss of oligodendrocytes. Examples deal with the diagnostic workup of enzyme deficiencies, demyelinating white matter diseases, and focal brain lesions
Multiple sclerosis in children and adolescents
No full textMultiple sclerosis (MS) is considered to be a disease of young adulthood, but it should be noted that cases in childhood and adolescence are not rare. Principally, childhood MS and MS in the adult age are the same disease. Nevertheless, there are some important differences concerning possible differential diagnoses, symptoms, clinical course and therapy. Of special interest is the fact that the prognosis of MS in childhood seems to be better than that of MS in the adult age, partially as a consequence of the lower percentage of primary and secondary progressive courses. Despite the fairly good prognosis of childhood MS, a consequent immunosuppressive treatment of acute attacks as well as a timely immunomodulatory therapy to slow down the progression of the disease is to be recommended. Yet the potential therapeutic benefit of such a treatment has to be carefully balanced against the presently unknown long-term risks of an immunomodulation early in life. Additionally, pharmacotherapy of childhood MS should always be part of a comprehensive therapeutic concept also considering physiotherapeutic and individual psychosocial care
Multiple sclerosis in childhood
No full textChildhood multiple sclerosis (MS) cannot be considered a rare disease since it constitutes about 5% of all MS-cases. A survey of cases in Germany showed over 150 new cases of definite or probable childhood MS from 1997 to 1999, the reel incidence of MS in childhood is most probably even higher. principally adult and childhood MS are the some disease but there ore important differences in possible differential diagnoses, symptoms, clinical course and therapy It is especially interesting that the prognosis in childhood MS appears to he better than in adult MS, mainly as a consequence of the lower percentage of primary and secondary progressive courses. Despite the better prognosis in childhood MS, a consequent immunosuppressive treatment of acute attacks as well as immunomodulatory therapy at the proper point in time to slow down the progression of the disease are recommended. The potential benefits of immunomodulation have to be balanced against the presently unknown long-term risks of such a therapy early in life
Multiple sclerosis in childhood
No full textChildhood multiple sclerosis (MS) cannot be considered a rare disease since it constitutes about 5% of all MS-cases. A survey of cases in Germany showed over 150 new cases of definite or probable childhood MS from 1997 to 1999, the reel incidence of MS in childhood is most probably even higher. principally adult and childhood MS are the some disease but there ore important differences in possible differential diagnoses, symptoms, clinical course and therapy It is especially interesting that the prognosis in childhood MS appears to he better than in adult MS, mainly as a consequence of the lower percentage of primary and secondary progressive courses. Despite the better prognosis in childhood MS, a consequent immunosuppressive treatment of acute attacks as well as immunomodulatory therapy at the proper point in time to slow down the progression of the disease are recommended. The potential benefits of immunomodulation have to be balanced against the presently unknown long-term risks of such a therapy early in life
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