AUTHOR=Papetti Laura , Figà Talamanca Lorenzo , Spalice Alberto , Vigevano Federico , Centonze Diego , Valeriani Massimiliano 

TITLE=Predictors of Evolution Into Multiple Sclerosis After a First Acute Demyelinating Syndrome in Children and Adolescents

JOURNAL=Frontiers in Neurology

VOLUME=Volume 9 - 2018

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2018.01156

DOI=10.3389/fneur.2018.01156

ISSN=1664-2295

ABSTRACT=Background/Objective: The aim of the study was to estimate the rate of evolution from a first acute demyelinating event (ADE) into multiple sclerosis (MS) in paediatric patients, and to investigate the variables that predict this evolution. 
Methods: We retrospectively evaluated the clinical and neuroradiological features of children presenting with a first ADE between January 2005 and April 2017. All included patients underwent baseline MRI, cerebro-spinal fluid and blood analysis, including virological examinations. Evolution into MS was determined by the 2013 International Paediatric Multiple Sclerosis Study Group (IPMSSG) criteria. Clinical and radiological features predictive of MS were determined using multivariate analyses. 
Results: Ninety-one patients were selected (mean age at onset: 10.11± 4.6). After a mean follow-up of 5.6 ± 2.3 years, 35% of patients evolved into MS. In the logistic multivariate analysis of clinical and laboratory data, the best predictors of evolution into MS were: the presence of oligoclonal bands in CSF (p<0.001), past infection with EBV (p<0.001), periventricular lesions (p<0.001), hypointense lesions on T1 (p <0.001) and lesions of the corpus callosum (p <0.001) including Dawson fingers (p<0.001). 
Conclusion: Our findings suggest a pattern of neuroimaging and laboratory findings that may help to distinguish, at clinical onset, children with a monophasic syndrome (clinically isolated syndrome or acute disseminated encephalomyelitis) from those who will develop MS.