Early Onset Of Multiple Sclerosis In A Two-Year-Old Girl: A Case Report
Palabras clave:
Pediatric demyelinating disease, multiple sclerosis, brainstem syndrome, neuroimagingResumen
Introduction: Multiple sclerosis (MS) is an immune-mediated demyelinating disorder that is extremely rare before the age of five. Its diagnosis is challenging due to its clinical and radiologic overlap with other pediatric demyelinating syndromes. Case Presentation: We describe a two-year-old girl with recurrent focal neurological deficits and multifocal MRI lesions showing dissemination in space and time. Alternative diagnoses including ADEM, NMOSD (AQP4-IgG-negative), infection, vasculitis, and MOGAD were excluded. She responded to high-dose IV methylprednisolone during relapses. After fulfilling McDonald criteria for MS, long-term therapy with interferon beta-1a was started, and she has remained clinically stable. Conclusions: This case highlights an exceptionally early presentation of pediatric-onset relapsing-remitting MS and underscores the need to consider MS even in very young children when clinical and radiologic findings are strongly suggestive.
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