Ophthalmological Findings in Paediatric and Adolescent Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system of unknown aetiology. The onset of MS in childhood poses diagnostic and therapeutic challenges. Differential diagnoses include acute disseminated encephalomyelitis and neurometabolic leukoencephalopathies. In this article the ophthalmological findings of paediatric and adolescent MS patients are described and discussed in the light of earlier studies. Methods: In a retrospective study we evaluated the ophthalmological and neuro-ophthalmological findings of 44 paediatric/adolescent MS patients (aged 8-18 years). Results: In 18/44 patients optic neuritis was found. Abnormalities of ocular motility were seen in 9/44 patients, 5/44 had abduction limitation, 3/94 internuclear ophthalmoplegia and 1/44 horizontal gaze palsy. Furthermore, 13/44 children showed nystagmus, mostly gaze-induced nystagmus. Uveitis was present in 4/44 patients. Conclusions: The ophthalmological and neuro-ophthalmological findings may lead to the diagnosis of MS. Children presenting with these symptoms should be examined by a paediatric neurologist.