[The type of involvement of the nervous system in multiple sclerosis in children and adolescents].

INTRODUCTION: The multiple sclerosis (MS) is characterized by variable clinical symptomatology, neuroradiological changes and neuropathological features, what influence the variable course of disease.

THE AIM: It was to describe the type of nervous system involvement in children with MS, considering the clinical manifestation and neuroradiological changes.

MATERIAL AND METHODS: 9 children with multiple sclerosis hospitalized in the Department of Pediatric Neurology Chair of Pediatric and Adolescent Neurology, in 2006 and 2007 year were included. There were 5 girls aged 14-17 years and 4 boys aged 10-17 years. The history, clinical examination as well as head MRI were performed in all children, and in 2 children the spinal cord MRI as well. McDonald's criteria were employed. In 8 children oligoclonal bands in the cerebrospinal fluid were examined, in 6 children VEP and in 4 BAEP as well.

RESULTS: The most common clinical manifestations of MS were superficial sensory deficits, vertigo and diplopia. In 4 children with two attacks of symptoms disseminated in OUN, the head MRI revealed disseminated demyelination in the brain and in 1 child also demyelination in the cervical spinal cord. In 3 of patients oligoclonal bands were detected, and also in 3 children pathological VEP. In 2 other children only 1 attack was observed with symptoms disseminated in CNS, correlating with neuroradiological picture, within in 1 of them clinically silent progression of demyelination was revealed in the second MRI. In other children hospitalized after first attack with clinically isolated syndrome, demyelination was disseminated CNS, and in the youngest male patients oligoclonal bands were positive.

CONCLUSIONS: The most common clinical manifestations of MS were superficial sensory deficits, vertigo and visual disturbances, the least typical was organic based psychotic manifestation. The most common MR changes were located in the white matter of centrum semiovale and in corona radiata.