Relapse severity and recovery in early pediatric multiple sclerosis

Alex J. Fay, Ellen M. Mowry, Jonathan Strober, Emmanuelle Waubant

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Background: Factors determining severity and recovery of early demyelinating events in pediatric multiple sclerosis (MS) patients are unknown. Objective: The objective of this study was to characterize the severity and recovery of early demyelinating events in pediatric MS. Methods: Multivariate logistic regression was performed to determine predictors of severe (versus mild/moderate) relapses and poor or fair (versus complete) recovery in patients aged 18 years or less with MS or clinically isolated syndrome (CIS). Results: Optic nerve involvement (OR 4.30, 95% CI 1.50-12.3, p = 0.007) was associated with a severe initial demyelinating event (IDE), while non-White race (OR 2.55, 95% CI 0.87-7.49, p = 0.088), localization to the cerebral hemispheres (OR 7.94, 95% CI 0.86-73.8, p = 0.068), or encephalopathy (OR 8.70, 95% CI 0.86-88.0, p = 0.067) showed a trend towards increased IDE severity. A similar association with race was found for severe second events. A severe IDE (OR 6.90, 95% CI 2.47-19.3, p < 0.001) was associated with incomplete IDE recovery, with similar trends for second and third events. Incomplete recovery from the first event predicted incomplete second event recovery (OR 3.36, 95% CI 0.98-11.6, p = 0.055). Conclusions: These results may help identify children at risk for a more aggressive disease course.

Original languageEnglish (US)
Pages (from-to)1008-1012
Number of pages5
JournalMultiple Sclerosis Journal
Issue number7
StatePublished - Jul 2012
Externally publishedYes


  • demyelinating disease
  • epidemiology
  • multiple sclerosis
  • pediatric
  • recovery
  • severity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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