Incidence of acquired demyelination of the CNS in Canadian children

被引：238

作者：

Banwell, B. ^{[1
]}

Kennedy, J.

Sadovnick, D. ^{[2
]}

Arnold, D. L. ^{[3
,4
]}

Magalhaes, S.

Wambera, K. ^{[5
]}

Connolly, M. B. ^{[6
]}

Yager, J. ^{[7
]}

Mah, J. K. ^{[8
]}

Shah, N. ^{[9
]}

Sebire, G. ^{[10
]}

Meaney, B. ^{[11
]}

Dilenge, M. -E. ^{[12
]}

Lortie, A. ^{[13
]}

Whiting, S. ^{[14
]}

Doja, A. ^{[14
]}

Levin, S. ^{[15
]}

MacDonald, E. A. ^{[16
]}

Meek, D. ^{[17
]}

Wood, E. ^{[18
]}

Lowry, N. ^{[19
]}

Buckley, D. ^{[20
]}

Yim, C. ^{[21
]}

Awuku, M. ^{[22
]}

Guimond, C. ^{[2
]}

Cooper, P. ^{[23
]}

Grand'Maison, F. ^{[24
]}

Baird, J. B. ^{[25
]}

Bhan, V. ^{[26
]}

Bar-Or, A. ^{[3
,4
]}

机构：

[1] Hosp Sick Children, Res Inst, Toronto, ON M5G 1X8, Canada

[2] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada

[3] Montreal Neurol Inst, Quebec City, PQ, Canada

[4] McGill Univ, Montreal, PQ, Canada

[5] Victoria Gen Hosp, Victoria, BC, Canada

[6] British Columbia Childrens Hosp, Vancouver, BC V6H 3V4, Canada

[7] Stollery Childrens Hosp, Edmonton, AB, Canada

[8] Alberta Childrens Prov Gen Hosp, Calgary, AB, Canada

[9] Childrens Hosp Winnipeg, Winnipeg, MB, Canada

[10] Ctr Hosp Univ Sherbrooke, Quebec City, PQ, Canada

[11] McMaster Childrens Hosp, Hamilton, ON, Canada

[12] Montreal Childrens Hosp, Quebec City, PQ, Canada

[13] Ctr Hosp Univ St Justine, Montreal, PQ, Canada

[14] Childrens Hosp Eastern Ontario, Ottawa, ON K1H 8L1, Canada

[15] Childrens Hosp Western Ontario, London, ON, Canada

[16] Queens Univ, Kingston, ON, Canada

[17] St Johns Hosp, New Brunswick, NJ USA

[18] IWK Hlth Ctr, Halifax, NS, Canada

[19] Royal Univ Hosp, Saskatoon, SK S7N 0W8, Canada

[20] Janeway Childrens Hlth & Rehabil Ctr, St John, NF, Canada

[21] Trillium Hlth Ctr, Mississauga, ON, Canada

[22] Windsor Reg Hosp, Windsor, ON, Canada

[23] Rouge Valley Centenary Hosp, Scarborough, ON, Canada

[24] Hop Charles LeMoyne, Montreal, PQ, Canada

[25] Sudbury Reg Hosp, Sudbury, ON, Canada

[26] Dalhousie MS Res Unit, Halifax, NS, Canada

来源：

NEUROLOGY | 2009年 / 72卷 / 03期

关键词：

ACUTE DISSEMINATED ENCEPHALOMYELITIS; PEDIATRIC MULTIPLE-SCLEROSIS; ACUTE TRANSVERSE MYELITIS; OPTIC NEURITIS; DIAGNOSTIC-CRITERIA; AUTOIMMUNE-DISEASE; CLINICAL-FEATURES; CHILDHOOD; POPULATION;

D O I：

10.1212/01.wnl.0000339482.84392.bd

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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. Neurology (R) 2009;72:232-239

引用

页码：232 / 239

页数：8

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