Multiple sclerosis (MS) most frequently involves patients whose age ranges from 20 to 40 years. However, in 3-10% of cases MS shows a clinical onset before the age of 18 years (pediatric onset MS - POMS). As compared to adult-onset MS (AOMS), POMS is characterized by a higher rate of relapses, due to the greater degree of inflammation within its pathophysiological mechanisms. Although patients with POMS reach irreversible disability after a longer time interval than those with AOMS, current literature has clearly shown that the children and adolescents with MD are likely to reach stages of irreversible disability at a younger age than patients diagnosed in adulthood. Moreover, there is evidence that POMS leads to progressive cognitive impairment, whose development should be carefully monitored as it is partially independent of MRI lesion charge and number of relapses. Despite these elements highlighting the need for an early and effective treatment of POMS, the therapeutic possibilities that are currently available for pediatric patients are still far narrower than those available for adults. While a number of randomized controlled trials (RCT) have tested safety and efficacy of several drugs in adult patients, pharmacological RCT have rarely been conducted in children and adolescents with MS, likely also due to the rarity of the disease in this age group.

The present Research Topic is aimed at collecting original research and review articles dealing with various aspects of POMS. Manuscripts investigating the clinical presentation peculiarities, development trajectories, and therapeutic options will be welcome. Additionally, description of case series and case reports, that unravel original aspects of the disease, can be submitted.

Thus, topic editors will welcome any types of manuscripts supported by the Journal – comprised of the research article, brief research article, review, and mini-review – pertaining, but not limited to the following themes:
• Biological markers of POMS
• MRI peculiarities in patients with POMS
• Predictive factors suggesting evolution of acute disseminated encephalomyelopathy (ADEM) in POMS
• Treatment of children with MS under the age of 10 years
• The meaning of antiMOG antibodies in patients with POMS
• First line vs. second line medications in patients with POMS
• Environmental factors affecting POMS severity

Prof. Lanzillo received personal compensations for speaking or consultancy from Biogen, Teva, Genzyme, Merck, Mylan, Novartis and Roche. No other conflicts of interest were declared.

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