Multiple sclerosis: biological differences in children and adults

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By Susan S Kim MD PhD and Mark A Agius MD

The behavior of the immune system in children with multiple sclerosis appears to parallel that in children with other chronic inflammatory diseases. Children with multiple sclerosis represent a group in whom a strategy of induction of remission and maintenance of remission is likely to prevent long-term disability. The developing nervous system is a particularly susceptible target of the immune system. At the same time, the potential for enhanced neural plasticity in children provides a unique opportunity for functional recovery along with long-term disability prevention.

Key Points

  • Epidemiological data support the concept of the onset of multiple sclerosis as a parainfectious process.
  • Development of chronic inflammation occurs in susceptible individuals on the basis of molecular characteristics of the individual’s immune system.
  • The central nervous system provides targets that maintain the long-term immune response, some of which are unique to children.
  • Age is an independent variable that, at least in part, determines the course of the disease in multiple sclerosis.
  • Monitoring effective immune therapy is important in preventing long-term disability.

In This Article

Historical note and nomenclature
Clinical applications
References cited