P136 – 2961: A review of a paediatric cases of multiple sclerosis in an Irish tertiary referral centre

Abstract

To examine a cohort of paediatric multiple sclerosis (MS) patients in an Irish tertiary paediatric neurology referral centre with emphasis on presentation, investigations and management, comparing to other described cohorts. Methods Patients were identified through department records, with chart review performed to obtain clinical details. Laboratory and radiological information was reviewed. Results Nine patients presented to the department over a 6 year period (3.5–15 yo). Female to male ratio was 2:1 with all patients of western European ethnicity. They presented 77% with brainstem syndromes, including visual problems (55%), sensory disturbance (44%), dizziness or ataxia (22%), reduced power or a cranial nerve palsy in 11%. Headache was a co-existing feature in 66%. One patient had no defining event but rather incidental findings on an MRI Brain. Family history was significant for MS (22%) and autoimmune condition (22%). Initial MRI brain shower cerebellar demyelinating lesions in 77% and spinal lesions in 55%. Oligoclonal bands were checked in all patients and positive in 66% with NMO antibodies checked in 66% which were negative. Clinical relapses occurred in 66% with a mean time to relapse 11 months. Steroids were commenced in 77% of patients in acute phase, with one patient commencing interferon beta 1a started directly from steroids due to ongoing symptoms. As maintenance treatment, interferon-beta-1a was started in all patients who relapsed or had deterioration in follow up imaging, with 2 progressing to fingolimod due to failed treatment. Two patients required no treatment due to either no symptoms or relapses. Conclusion Our patient study reflected previous described patient cohorts especially in their presentations, investigations and relapsing-remitting course [1,2]. Our female to male ratio was lower than previously described [1]. We also had high rates of positive family history of both autoimmune disease and Multiple sclerosis. Treatment for these patients followed international guidelines [3].