Demyelination in Adolescence: A Case Series on Pediatric-onset Multiple Sclerosis in the United Arab Emirates

Introduction: Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease affecting the central nervous system. Pediatric-onset MS, diagnosed in individuals under 18 years of age, is increasingly recognized as a distinct entity, with an annual incidence of 0.13-0.6 cases per 100,000 children. Diagnosis is challenging due to symptom overlap with other neurological conditions. This case series presents two pediatric MS cases detailing symptoms, diagnostic findings, treatments, and outcomes.Case Report: Case 1 involved a previously healthy 17-year-old male with progressive left-sided weakness and difficulty walking. Magnetic resonance imaging (MRI) scans showed multiple enhancing periventricular lesions, with cerebrospinal fluid analysis revealing 12 oligoclonal bands and human herpesvirus 6 (HHV-6) positivity. Treatment with intravenous methylprednisolone and physiotherapy led to significant improvement. Case 2 featured a 14-year-old girl with vomiting and double vision, exhibiting left internuclear ophthalmoplegia. MRI revealed juxtacortical, periventricular, and brainstem demyelinating lesions, and cerebrospinal fluid analysis confirmed oligoclonal bands, leading to a diagnosis of relapsing-remitting MS, managed successfully with intravenous steroids.Conclusion: Pediatric-onset MS necessitates early recognition and comprehensive management. Prompt initiation of disease-modifying therapies and psychosocial support enhances quality of life and mitigates disease progression. Further research is essential to elucidate its etiology and risk factors.