Acquiring new insights

Epidemiology studies have elucidated many key aspects of multiple sclerosis (MS). In adults, MS is more common in women and white individuals of Northern European heritage. The relative representation of sex, race, and heritage in pediatric MS is less well understood. MS is not thought to occur as a random event, but rather is considered a multifactorial disease influenced by both genetic and environmental factors, which can only be identified through the careful examination of disease in different populations over time.¹ The study of MS in children offers a unique opportunity to explore the interplay between environmental, genetic, and hormonal factors in the developing immune and nervous systems. This process begins with identifying patients at risk—children presenting with acquired demyelinating syndromes (ADS), such as clinically isolated syndromes, including optic neuritis and transverse myelitis.

Although MS and ADS are increasingly recognized in children, the incidence and prevalence are largely unknown. In this issue of Neurology^®, Langer-Gould et al.² report incidence rates of MS and ADS for children in the United States for the first time. Using an electronic database of inpatient and outpatient records of Kaiser Permanente Southern California, a large health maintenance organization, the authors identified children presenting with demyelinating diseases through International Classification of Diseases (ICD)–9 codes …