Incidence of acquired demyelination of the CNS in Canadian children Academic Article uri icon

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abstract

  • BACKGROUND: The incidence of acquired demyelination of the CNS (acquired demyelinating syndromes [ADS]) in children is unknown. It is important that physicians recognize the features of ADS to facilitate care and to appreciate the future risk of multiple sclerosis (MS). OBJECTIVE: To determine the incidence, clinical features, familial autoimmune history, and acute management of Canadian children with ADS. METHODS: Incidence and case-specific data were obtained through the Canadian Pediatric Surveillance Program from April 1, 2004, to March 31, 2007. Before study initiation, a survey was sent to all pediatric health care providers to determine awareness of MS as a potential outcome of ADS in children. RESULTS: Two hundred nineteen children with ADS (mean age 10.5 years, range 0.66-18.0 years; female to male ratio 1.09:1) were reported. The most common presentations were optic neuritis (ON; n = 51, 23%), acute disseminated encephalomyelitis (ADEM; n = 49, 22%), and transverse myelitis (TM; n = 48, 22%). Children with ADEM were more likely to be younger than 10 years, whereas children with monolesional ADS (ON, TM, other) were more likely to be older than 10 years (p < 0.001). There were 73 incident cases per year, leading to an annual incidence of 0.9 per 100,000 Canadian children. A family history of MS was reported in 8%. Before study initiation, 65% of physicians indicated that they considered MS as a possible outcome of ADS in children. This increased to 74% in year 1, 81% in year 2, and 87% in year 3. CONCLUSION: The incidence of pediatric acquired demyelinating syndromes (ADS) is 0.9 per 100,000 Canadian children. ADS presentations are influenced by age.

authors

  • Banwell, B
  • Kennedy, J
  • Sadovnick, D
  • Arnold, DL
  • Magalhaes, S
  • Wambera, K
  • Connolly, MB
  • Yager, J
  • Mah, JK
  • Shah, N
  • Sebire, G
  • Meaney, Brandon
  • Dilenge, M-E
  • Lortie, A
  • Whiting, S
  • Doja, A
  • Levin, S
  • MacDonald, EA
  • Meek, D
  • Wood, E
  • Lowry, N
  • Buckley, D
  • Yim, C
  • Awuku, M
  • Guimond, C
  • Cooper, P
  • Grand'Maison, F
  • Baird, John Burke
  • Bhan, V
  • Bar-Or, A

publication date

  • January 20, 2009

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