ABSTRACT
We report our experience concerning clinical and paraclinical features of multiple sclerosis in 19 children. The disease was highly variable in its presentation but acute episodes of retrobulbar optic neuritis or transverse myelitis or cerebellitis were commonly observed at the onset. Diagnosis was very often suspected as soon as the first episode when there was clinical evidence of more than one lesion (43%) or study of the cerebrospinal fluid demonstrated a local secretion of immunoglobulins (60%). Evoked potential studies and nuclear magnetic resonance imaging were performed during the course of the disease and exhibited abnormalities of the kind observed in adult patients and with a similar frequency; this suggests that such studies can be very useful in the evaluation of children suspected of having multiple sclerosis. When the initial form of the disease was a chronic myelopathy, the course was progressive from the onset, leading rapidly to a marked invalidity (15%). Most often a succession of relapses and remissions occurred after the first attack and major sequelae appeared 5 to 10 years later. Such features are not very different from those observed in adult patients and suggest that these patients can benefit from the progress resulting from therapeutic trials in adult patients.
Subject(s)
Multiple Sclerosis/physiopathology , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Multiple Sclerosis/cerebrospinal fluid , Multiple Sclerosis/diagnosis , Physical ExaminationABSTRACT
Ultrasound images in 6 patients with hyperechogenic "pseudo-nodules" of diaphragmatic origin were analyzed. In each case the findings corresponded to variations in curve of right diaphragmatic dome on radiology, but these diaphragmatic bumps were not associated routinely by a pseudo-nodule. A semiologic explanation for the formation of the ultrasound image is suggested.
