Relapsing inflammatory demyelinating syndromes amongst children in Borneo

ABSTRACT

We present a case series of children with relapsing inflammatory demyelination who live on the island of Borneo, a relatively rural region of South East Asia with a warm, tropical climate. The four cases are a 9 year old girl with a polyfocal clinically isolated syndrome who had a single recurrence of symptoms soon after completing steroid taper, a 6 year old boy with relapsing-remitting multiple sclerosis (MS), an 8 year old boy with relapsing neuromyelitis optica and an 8 year old boy with chronic recurrent optic neuritis (CRION). The clinical presentation and neuroimaging features in our children are similar those seen in children living in temperate world regions. The new recommendations by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) in classifying childhood inflammatory demyelinating disorders are useful in our children. This report hopes to raise awareness of relapsing inflammatory demyelinating syndromes in children living in a region with a low risk for MS.