Esclerosis múltiple en pacientes pediátricos: fisiopatología, diagnóstico y manejo.

Objective: Review about Multiple Sclerosis in pediatric patients, emphasizing in pathophysiological factors, diagnostic methods, main differential diagnosis, treatment, and prognosis, thus providing current knowledge about this pathology. Methods: Search of articles was made in PubMed and Scopus databases with key words "multiple sclerosis", "children", "pediatric multiple sclerosis", "pathophysiology", "diagnosis", "diagnostic criteria", and "treatment". Selected articles must have a publication date after 2000, reviews or clinical trials, and have been published in English or Spanish languages. Results and Conclusions: Multiple sclerosis is a disease with an incidence of 2 to 4 per 100,000 habitants in Colombia, and pediatric population represents 2.7 to 5% of the cases. Multiple causes had been related to the disease, including environmental factors, such as viral or bacterial infections, tobacco smoke exposure or Vitamin D deficiency, among others; genetic and immunologic causes are exposed too. Diagnosis is based in clinical and imaging features, excluding previously other more common diseases. Management is divided in three axes: treatment of acute event, disease-modifying therapies and symptomatic therapy. The treatment of acute events is usually with corticoid therapy, for disease-modifying therapy the first election are immunomodulatory drugs, such as Glatiramer Acetate and for symptomatic therapy is necessary a multidisciplinary approach. Long-term prognosis is variable and depends of treatment response. [ABSTRACT FROM AUTHOR]