Neurology 2016 Supplement:
The field of pediatric-onset multiple sclerosis (MS) and other demyelinating disorders in childhood has advanced considerably since the last International Pediatric MS Study Group-sponsored supplement was published in Neurology in 2007.
The 2016 Neurology supplement summarizes new insights related to pediatric demyelinating disorders in sixteen articles by subject experts. The goal of each article was to bring together a team of international contributors with diverse areas of expertise to: compile a critical state of the art review on current knowledge; reach consensus on recommendations where clear-cut evidence is still lacking; and discuss controversies and future directions.
Together, the articles in this supplement highlight the advances, unanswered questions and new challenges in the diagnosis, understanding and management of pediatric-onset MS and other demyelinating disorders.
Pediatric demyelinating disorders: Global updates, controversies, and future directions. Tanuja Chitnis, Daniela Pohl, On behalf of the International Pediatric MS Study Group (IPMSSG) Steering Committee.
Neurology August 30, 2016 87:S1-S3
Pediatric multiple sclerosis: Perspectives from adolescents and their families. Lauren B. Krupp, David Rintell, Leigh E. Charvet, Maria Milazzo, and Evangeline Wassmer.
Neurology August 30, 2016 87:S4-S7
Consensus definitions for pediatric MS and other demyelinating disorders in childhood. Marc Tardieu, Brenda Banwell, Jerry S. Wolinsky, Daniela Pohl, and Lauren B. Krupp.
Neurology August 30, 2016 87:S8-S11
Immunopathophysiology of pediatric CNS inflammatory demyelinating diseases. Amit Bar-Or, Rogier Q. Hintzen, Russell C. Dale, Kevin Rostasy, Wolfgang Brück, and Tanuja Chitnis.
Neurology August 30, 2016 87:S12-S19
Environmental and genetic factors in pediatric inflammatory demyelinating diseases. Emmanuelle Waubant, Anne-Louise Ponsonby, Maura Pugliatti, Heather Hanwell, Ellen M. Mowry, and Rogier Q. Hintzen.
Neurology August 30, 2016 87:S20-S27
Differential diagnosis and evaluation in pediatric inflammatory demyelinating disorders. Kevin Rostasy, Barbara Bajer-Kornek, Sunita Venkateswaran, Cheryl Hemingway, and Marc Tardieu.
Neurology August 30, 2016 87:S28-S37
Acute disseminated encephalomyelitis: Updates on an inflammatory CNS syndrome. Daniela Pohl, Gulay Alper, Keith Van Haren, Andrew J. Kornberg, Claudia F. Lucchinetti, Silvia Tenembaum, and Anita L. Belman.
Neurology August 30, 2016 87:S38-S45
Pediatric transverse myelitis. Michael Absoud, Benjamin M. Greenberg, Ming Lim, Tim Lotze, Terrence Thomas, and Kumaran Deiva.
Neurology August 30, 2016 87:S46-S52
Pediatric optic neuritis. Ann Yeh, Jennifer S. Graves, Leslie A. Benson, Evangeline Wassmer, and Amy Waldman.
Neurology August 30, 2016 87:S53-S58
Neuromyelitis optica spectrum disorders in children and adolescents. Silvia Tenembaum, Tanuja Chitnis, Ichiro Nakashima, Nicolas Collongues, Andrew McKeon, Michael Levy, and Kevin Rostasy.
Neurology August 30, 2016 87:S59-S66
Pediatric acquired CNS demyelinating syndromes: Features associated with multiple sclerosis. Rogier Q. Hintzen, Russell C. Dale, Rinze F. Neuteboom, Soe Mar, and Brenda Banwell.
Neurology August 30, 2016 87:S67-S73
Pediatric multiple sclerosis: Clinical features and outcomes. Amy Waldman, Jayne Ness, Daniela Pohl, Isabella Laura Simone, Banu Anlar, Maria Pia Amato, and Angelo Ghezzi.
Neurology August 30, 2016 87:S74-S81
Pediatric multiple sclerosis: Cognition and mood. Maria Pia Amato, Lauren B. Krupp, Leigh E. Charvet, Iris Penner, and Christine Till.
Neurology August 30, 2016 87:S82-S87
MRI in the evaluation of pediatric multiple sclerosis. Brenda Banwell, Douglas L. Arnold, Jan-Mendelt Tillema, Maria A. Rocca, Massimo Filippi, Bianca Weinstock-Guttman, Robert Zivadinov, and Maria Pia Sormani.
Neurology August 30, 2016 87:S88-S96
Pediatric multiple sclerosis: Conventional first-line treatment and general management. Angelo Ghezzi, Maria Pia Amato, Naila Makhani, Teri Shreiner, Jutta Gärtner, and Silvia Tenembaum.
Neurology August 30, 2016 87:S97-S102
Pediatric multiple sclerosis: Escalation and emerging treatments. Tanuja Chitnis, Angelo Ghezzi, Barbara Bajer-Kornek, Alexey Boyko, Gavin Giovannoni, and Daniela Pohl.
Neurology August 30, 2016 87:S103-S109
International Pediatric MS Study Group Global Members Symposium report. Evangeline Wassmer, Tanuja Chitnis, Daniela Pohl, Maria Pia Amato, Brenda Banwell, Angelo Ghezzi, Rogier Q. Hintzen, Lauren B. Krupp, Naila Makhani, Kevin Rostásy, Marc Tardieu, Silvia Tenembaum, Amy Waldman, Emmanuelle Waubant, and Andrew J. Kornberg.
Neurology August 30, 2016 87:S110-S116
IPMSSG’s paper was endorsed by the European MS Platform.
Read our article on the need for clinical drug trials in pediatric MS in the European MS Platform.
Chitnis T, Tardieu M, Amato MP, Banwell B, Bar-Or A, Ghezzi A, Kornberg A, Krupp L, Pohl D, Rostasy K, Tenembaum S, Waubant E, Wassimer E. International Pediatric MS Study Group Clinical Trials Summit: meeting Report. Neurology. 2013 Mar 19;80(12):1161-8. PMID: 23509048; PMCID: PMC3662305.
This paper is a summary of a meeting that took place in Washington DC in January 2012 between members of the IPMSSG, regulatory agency representatives (FDA, EMA and Health Canada), pharmaceutical company representatives and patient groups. It outlines consensus guidelines from this meeting for the conduct of clinical trials in children with MS.
Krupp L, Tardieu M, Krupp LB1, Tardieu M, Amato MP, Banwell B, Chitnis T, Dale RC, Ghezzi A, Hintzen R, Kornberg A, Pohl D, Rostasy K, Tenembaum S, Wassmer E; International Pediatric Multiple Sclerosis Study Group. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Multiple Sclerosis Journal 2013 Sep;19(10):1261. Epub 2013 Apr 9. PMID: 23572237.
In 2007, the initial International Pediatric MS Study Group (IPMSSG) proposed provisional definitions for pediatric acquired demyelinating disorders of the central nervous system. The definitions were designed to improve consistency in terminology, foster clinical research, and facilitate epidemiological studies in pediatric demyelination. Subsequent research has illustrated the 2007 IPMSSG definitions’ strengths and limitations and the body of knowledge regarding pediatric MS and other immune mediated CNS demyelinating disorders of childhood has grown substantially. This paper reviews and updates the original definitions with revised criteria that can be used for clinical research purposes or as general guidelines in patient management.
Chitnis T, Tenembaum S, Banwell B, Krupp L, Pohl D, Rostasy K, Yeh EA, Bykova O, Wassmer E, Tardieu M, Kornberg A, Ghezzi A; International Pediatric MS Study Group. Evaluation of new and existing therapeutics for pediatric MS. Multiple Sclerosis. 2012 Jan;18(1):116-27. Epub 2011 Dec 6. PMID: 22146610.
This paper summarizes the current treatment practice and available data on treatment efficacy in pediatric MS (as of 2011), and summarizes the views of 50 IPMSSG members on the need for well-conducted clinical trials in pediatric MS.
Hanefeld F. Pediatric multiple sclerosis: A short history of a long story. Neurology 2007 April 17; 68 (16) Suppl 2: S3-S6. PMID: 17438236.
This paper summarizes the history of observations of multiple sclerosis in children shortly after MS was described by Charcot in 1872-1873. At the time of these late 19th century observations many inherited demyelinating diseases that manifest during childhood had not yet been recognized. Present challenges in the differential diagnoses of demyelinating disorders presenting in childhood are reflected in the history of pediatric MS.
Krupp L, Banwell B, Tenembaum S for the International Pediatric MS Study Group.
Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology 2007 April 17; 68 (16) Suppl 2: S3-S12. PMID: 17438241.
This paper proposes clinical definitions for pediatric multiple sclerosis, acute disseminated encephalomyelitis (ADEM), recurrent ADEM, multiphasic ADEM, neuromyelitis optica, and clinically isolated syndrome. It highlights that the definitions are operational and need to be tested in future research and modified accordingly.
Hahn J, Pohl D, Rensel, M, Rao S for the International Pediatric MS Study Group. Differential diagnosis and evaluation in pediatric multiple sclerosis. Neurology 2007 April 17; 68 (16) Suppl 2: S13-S22. PMID:17438234.
This paper summarizes differential diagnosis for MS in childhood and adolescence which includes infectious, inflammatory and neoplastic disorders as well as metabolic neurogenetic leukodystrophies, and vascular conditions. Evaluation is determined by the clinical and neuroradiologic presentation. A minimal diagnostic battery is proposed.
Tenembaum S, Chitnis T, Ness J, Hahn J for the International Pediatric MS Study Group. Acute disseminated encephalomyelitis. Neurology 2007 April 17; 68 (16) Suppl 2: S23-S36. PMID:17438235.
This paper summarizes presenting features of acute disseminated encephalomyelitis (ADEM). Although ADEM usually has a monophasic course, recurrent or multiphasic forms have been reported, raising diagnostic difficulties in distinguishing these cases from MS. The International Pediatric MS Study Group proposes uniform definitions for ADEM and its variants.
Ness J, Chabas D, Sadovnick, D, Pohl D, Banwell B, Weinstick-Guttman B for the International Pediatric MS Study Group. Clinical features of children and adolescents with multiple sclerosis. Neurology 2007 April 17; 68 (16) Suppl 2: S37-S45. PMID: 17438237.
This paper reviews the clinical characteristics, neuroimaging, paraclinical findings, disease course, epidemiology, genetics and pathophysiology of pediatric MS vis-à-vis adult MS.
Banwell B, Shroff M, Ness J, Jeffrey D, Schwid S and Weinstick-Guttman B for the International Pediatric MS Study Group. MRI features of pediatric multiple sclerosis. Neurology 2007 April 17; 68 (16) Suppl 2: S46-S53. PMID: 17438238.
This paper summarizes the available literature on MRI in pediatric MS, outlines the specific features of other disorders affecting the CNS white matter in children, compares the MRI appearance of MS in children to seminal neuroimaging studies in adult-onset MS, and discusses the potential role of advanced MRI technologies in delineating the underlying pathobiology of acquired demyelinating disease in children.
Pohl D, Waubant E, Banwell B, Chabas D, Chitnis T, Weinstick-Guttman B, Tenembaum S for the International Pediatric MS Study Group. Treatment of pediatric multiple sclerosis and variants. Neurology 2007 April 17; 68 (16) Suppl 2: S54-S65. PMID: 17438239.
This paper summarizes current knowledge of disease modifying treatment in pediatric MS and experience in several centres treating pediatric MS and MS variants such as neuromyelitis optica or Devic disease, Balo concentric sclerosis, Marburg acute MS, and Schilder disease (myelinoclastic diffuse sclerosis). An overview of symptomatic MS therapies and experiences with these treatments is provided.
MacAllister, W, Boyd J, Holland N, Milazzo M, Krupp L for the International Pediatric MS Study Group. The psychosocial consequences of pediatric multiple sclerosis. Neurology 2007 April 17; 68 (16) Suppl 2: S66-S69. PMID: 17438240.
This paper reviews the psychosocial distress and cognitive dysfunction associated with MS which is well documented in adults with MS but poorly understood in children with MS. Psychosocial difficulty experienced by children and adolescents with MS involves factors common to all chronic illness in children, as well as MS-specific factors.
Belman A, Chitnis T, Renoux C, Waubant E for the International Pediatric MS Study Group. Challenges in the classification of pediatric multiple sclerosis and future directions. Neurology 2007 April 17; 68 (16) Suppl 2: S70-S74. PMID: 17438242.
This paper summarizes the issues raised during the development of case definitions of pediatric MS and related CNS demyelinating disorders as have been proposed by the International Pediatric MS Study Group. It also highlights potential international multicenter research studies that would be facilitated by the application of a uniform set of definitions.