Functional Relapses in Pediatric Multiple Sclerosis
Abstract
Multiple sclerosis in children is characterized by more frequent relapses than in adult patients. Diagnosing and treating youth with multiple sclerosis present a number of challenges including differentiating organic relapses from functional symptoms. However, there is no literature describing coexistence of functionality in pediatric multiple sclerosis. Here, we report 2 cases in which inconsistency between clinical history, physical examination, imaging, and atypical disease progression led to suspicion of functional relapses. The purpose of this study is to raise awareness of functional relapses, as prompt recognition can prevent overtreatment and iatrogenic risks in children and adolescents with multiple sclerosis. Underlying psychiatric issues also need to be addressed.
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Studies of MS "pseudorelapses" in children and adults have highlighted that FND can be a potential cause of an apparent MS relapse.
“Studies of MS “pseudorelapses” in children [50] and adults [51, 52] have highlighted that FND can be a potential cause of an apparent MS relapse.”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [50]
Cites
Anxiety in children and adolescents with chronic physical illnesses: a meta‐analysis
Pinquart, M., & Shen, Y. (2011) · Acta Paediatrica · doi:10.1111/j.1651-2227.2011.02223.x · Cited by 170 · see citing works
Anxiety in medically ill children/adolescents
Pao, M., & Bosk, A. (2011) · Depression and Anxiety · doi:10.1002/da.20727 · Cited by 151 · see citing works
Psychogenic Seizures in Children: Long-Term Analysis of 43 Cases
Lancman, M. E., Asconapé, J. J., Graves, S., & Gibson, P. A. (1994) · Journal of Child Neurology · doi:10.1177/088307389400900413 · Cited by 92 · see citing works
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Walzl, D., Solomon, A. J., & Stone, J. (2022) · Journal of Neurology · doi:10.1007/s00415-021-10436-6 · Cited by 62 · see citing works
- Authors
- Carbonell, C. F., Benson, L., Rintell, D., Prince, J., & Chitnis, T.
- Affiliations
- Massachusetts General Hospital (US)
- Corresponding author
- Chitnis, Tanuja
- Venue
- Journal of Child Neurology
- Publisher
- SAGE Publications
- Published
- 2013-09-23
- Volume
- 29
- Issue
- 7
- Pages
- 943-946
- ISSN
- 0883-0738 (ISSN-L)
- 1708-8283
- OpenAlex
- W2079115957
- Cited by
- 9
- References
- 3
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2016: 1 · 2015: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Multiple Sclerosis Society
- Massachusetts General Hospital
- Multiple Sclerosis Society
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- pediatric multiple sclerosis, relapse diagnosis, overtreatment, iatrogenic risk, psychiatric comorbidity, children and adolescents
- MeSH terms
- Adolescent, Female, Humans, Multiple Sclerosis, Pediatrics, Recurrence
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