Multiple Sclerosis in Children and Adults: Does Age Matter?

Patients with pediatric-onset multiple sclerosis (POMS), in comparison with adults with multiple sclerosis (MS), show a higher relapse rate, a more rapid accrual of lesions on MRI early in the disease course, and an increased risk of cognitive and physical disabilities in the long term.1 Despite the higher inflammation, patients with POMS demonstrate a slower rate of disability accrual compared to patients with adult-onset MS (AOMS). In a comparative study between 710 patients with AOMS and 83 patients with POMS, the pediatric group had a lower Expanded Disability Status Scale (EDSS) score at the last clinical examination, despite a longer disease duration.2 This has been hypothesized to result from greater plasticity of the developing brain in children and consequently greater capacity for repair.

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