Although almost all MS patients develop their initial symptoms during young to middle adulthood, the disease can occur at virtually any age. Convincing cases in childhood have been reported as early as 15 months (24-26), with onset younger than age 10 occurring in about 0.3% of cases (27-29). The early-onset disease does not appear to differ clinically from that starting late, although there may be an even greater female preponderance in this age group (30).
Onset of the disease after the age of 50 has been considered rare, although a more recent report suggests that MS may be more common than suspected in older individuals (31). New techniques facilitating diagnosis are contributing to increased recognition of cases in this age population. When the disease begins after the age of 40, it tends more often to follow a progressive course, particularly characterized by worsening spastic paraparesis (32-35).
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