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Diagnosis and management of multiple sclerosis and other relapsing demyelinating disease in childhood
  1. Aphra Luchesa Smith1,
  2. Nikil Sudarsan2,
  3. Cheryl Hemingway3,
  4. Ming Lim4,5
  1. 1 Medical School, University College London, London, UK
  2. 2 Department of Paediatric Neurology, Royal Alexandra Children's Hospital, Brighton, UK
  3. 3 Department of Neurology, Great Ormond Street Hospital for Children, London, UK
  4. 4 Children's Neurosciences, Evelina London Children's Hospital, London, UK
  5. 5 Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Cheryl Hemingway, Department of Neurology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK; cheryl.hemingway{at}


There are several important relapsing demyelinating syndromes (RDS) that may present in childhood, of which paediatric-onset multiple sclerosis is the most common. These are rare conditions, so recognising presentations and referring early to specialist services is important to enable prompt diagnosis and effective treatment. Understanding of RDS is rapidly evolving, with many new and effective treatments that aim to reduce relapses and disability accumulation. A holistic and child-focused approach to management is key to supporting patients and families, with thought given to early detection of cognitive and psychological issues to provide appropriate support.

  • therapeutics
  • syndrome
  • pathology
  • pharmacology
  • psychology

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  • Contributors ALS, CH and ML constructed main components of the review. ALS drafted the initial manuscript, designed the figures and tables. CH, ML and NS reviewed, revised and refined all versions of the manuscripts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CH has received educational grants from Biogen and provided consultant advice for Novartis, VielaBio and Biogen. Dr Ming Lim receives research grants from Action Medical Research, the DES Society, GOSH Charity, National Institute for Health Research, MS Society and SPARKS Charity; receives research support grants from the London Clinical Research Network and Evelina Appeal; has received consultation fees from CSL Behring, Novartis and Octapharma; received travel grants from Merck Serono; and was awarded educational grants to organise meetings by Novartis, Biogen Idec, Merck Serono and Bayer.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.