Author(s): Araújo, Daniela ; Pereira, Ângela ; A. Martins, Sofia ; Maré, Ricardo ; Cerqueira, João ; Carvalho, Susana
Date: 2024
Origin: SINAPSE
Subject(s): Adolescent; Multiple Sclerosis/diagnosis; Multiple Sclerosis/diagnostic imaging; Adolescente; Esclerose Múltipla/diagnóstico; Esclerose Múltipla/diagnóstico por imagem
Although multiple sclerosis’ (MS) diagnosis is usually made in adulthood, clinical presentation before the age of 18 occurs in up to 10% of the individuals. McDonald’s criteria applicability in diagnosing MS in adolescents is already established with the 2010 revision. The first clinical case we present is an adolescent with a family history of MS and a right retrobulbar optic neuritis’ presentation. Magnetic resonance imaging revealed periventricular and infratentorial lesions white matter lesions. The second case describes an adolescent with a suggestive presentation of acute transverse myelitis, with a sensitive level in D10 and multiple brain and spinal inflammatory lesions. Cerebrospinal fluid oligoclonal bands were present in both patients. Both met the 2017 McDonald criteria for MS diagnosis. MS diagnosis is particularly difficult in children and adolescents. A high degree of suspicion is needed. Differential diagnosis with other cerebral inflammatory disorders must be considered.
