'Natalizumab in paediatric multiple sclerosis and service implication'.

摘要

SIR-The recent paper by Karenfort et al.1 in DMCN raises important issues in the treatment of multiple sclerosis (MS) in children, and not just the potential benefit of disease-modifying treatment (DMT), as illustrated by the following patient.A 7-year-old male presented to Alder Hey Children's Hospital with ataxia, double vision, and internuclear oph-thalmoplegia. Magnetic resonance imaging (MRT) revealed multiple areas of high signal in the cerebral and cerebellar hemispheres and brainstem. Cerebrospinal fluid (CSF) analysis showed 10 monocytes, an elevated protein level, and positive oligoclonal bands. The differential diagnosis included acute disseminated encephalomyelitis or a clinically isolated syndrome. Recovery was complete following intravenous methylprednisolone; MRI6 weeks after admission showed a new lesion in the cerebellum.