Pediatric Multiple Sclerosis in Tunisia: A Retrospective Study over 11 Years

Table 2

CSF analysis and neuroimaging findings in our series.

	CSF analysis; (at onset)	Repeat CSF analysis	Brain and spinal MRI	Neurophysiological studies
Patient 1	Positive OCB	—	Periventricular, subcortical hyperintense lesions on T2 and FLAIR weighted images with right thalamus and pontine involvement and gadolinium enhancement	Normal VEP
Patient 2	Positive OCB, increased protein level	—	Brainstem, cerebellar, and insular subcortical hyperintense lesions on T2 and FLAIR weighted images without gadolinium enhancement	Optic neuritis
Patient 3	Normal	Positive OCB	Periventricular, subcortical hyperintense lesions on T2 and FLAIR weighted images with brainstem and cerebellar involvement	Optic neuritis
Patient 4	Negative OCB, increased protein level	Positive OCB	Subcortical hyperintense lesions on T2 and FLAIR weighted images with basal ganglia, brainstem, and posterior cordonal involvement	Optic neuritis
Patient 5	Positive OCB, increased protein level	—	Periventricular and subcortical hyperintense lesions on T2 and FLAIR weighted images with internal capsule, corpus callosum, thalamic, brainstem, and cerebellar peduncle involvement, extensive posterior spinal abnormalities, and gadolinium enhancement (Figure 1)	Optic neuritis, altered BAEP and SEP
Patient 6	Normal	Positive OCB	Periventricular and subcortical hyperintense lesions on T2 and FLAIR weighted images with brainstem and cervical involvement without gadolinium enhancement	Altered BAEP
Patient 7	Negative OCB, increased protein level	Normal	Periventricular hyperintense lesions on T2 and FLAIR weighted images with “onion bulb” appearance of one lesion and gadolinium enhancement	Altered BAEP
Patient 8	Normal	Positive OCB	Periventricular and semiovale center hyperintense lesions on T2 and FLAIR weighted images with internal capsule involvement	Altered SEP
Patient 9	Negative OCB, increased protein level	Positive OCB	Subcortical hyperintense lesions on T2 and FLAIR weighted images with cervical involvement and gadolinium enhancement	Altered SEP
Patient 10	Positive OCB	—	Periventricular, subcortical, semiovale center hyperintense lesions on T2 and FLAIR weighted images with corpus callosum, peduncular, pontine, and cerebellar involvement and cervical and dorsal abnormalities	Not performed
Patient 11	Increased cell count	Normal	Periventricular, subcortical, semiovale center hyperintense lesions on T2 and FLAIR weighted images with corpus callosum and cerebellar peduncles involvement and gadolinium enhancement	Normal VEP
Patient 12	Normal	Positive OCB	Corpus callosum hyperintense lesions on T2 and FLAIR weighted images with cerebellar and brainstem involvement and cervical abnormalities with gadolinium enhancement	Optic neuritis
Patient 13	Increased cell count	Normal	Periventricular hyperintense lesions on T2 and FLAIR weighted images with cervical involvement	Optic neuritis
Patient 14	Positive OCB, increased protein level and cell count	Positive OCB with normal cell count	Periventricular hyperintense lesions on T2 and FLAIR weighted images with cervical involvement and gadolinium enhancement	Optic neuritis, altered SEP
Patient 15	Increased cell count	Positive OCB with normal cell count	Periventricular hyperintense lesions on T2 and FLAIR weighted images	Normal VEP
Patient 16	Normal	Positive OCB	Periventricular hyperintense lesions on T2 and FLAIR weighted images with cerebellar and brainstem involvement	Not performed
Patient 17	Normal	Positive OCB	Periventricular hyperintense lesions on T2 and FLAIR weighted images with cervical involvement	Optic neuritis, altered SEP
Patient 18	Positive OCB	—	Periventricular and semiovale center hyperintense lesions on T2 and FLAIR weighted images with corpus callosum, brainstem, and cerebellar involvement	Optic neuritis, altered SEP
Patient 19	Positive OCB,; increased protein level and cell count	Positive OCB with normal cell count	Periventricular hyperintense lesions on T2 and FLAIR weighted images with brainstem involvement	Bilateral optic neuritis
Patient 20	Not performed	—	Periventricular hyperintense lesions on T2 and FLAIR weighted images with “onion bulb” aspect of some lesions	Optic neuritis, altered SEP
Patient 21	Positive OCB and increased protein level	—	Subcortical hyperintense lesions on T2 and FLAIR weighted images with cerebellar, cervical, and dorsal involvement	Altered SEP

OCB: oligoclonal bands; BAEP: brain auditory evoked potentials; SEP: sensory evoked potentials; VEP: visual evoked potentials.