Pediatric multiple sclerosis: update in diagnosis and management.

(1.2) but increases to 4.2 when age at onset is 13–15 years [3] . The loss of locomotor function, as measured by the Expanded Disability Status Scale, takes longer from the time of first attack in pediatricversus adult-onset MS, but pediatric patients reach disability milestones at a younger age than their adult counterparts. Comparative magnetic resonance imaging (MRI) studies have shown a higher lesion burden in children with MS compared with adults, supporting the concept that pediatric MS is more inflammatory than adult disease [4] .