The association between cognitive functioning and clinical features of 37 children (ages 8-17; mean 14.8 years) with a diagnosis of multiple sclerosis (MS) is reported from the State University of New York at Stony Brook, NY. Thirteen (35%) had cognitive impairment, especially in attention, memory and language, and required academic assistance in school. The majority was on disease modifying drug therapy, and 48% suffered from fatigue. Six of 13 given a structured psychiatric evaluation had an affective disorder. The degree of disability, number of relapses, total disease length, and age at onset were correlated with cognitive dysfunction. At one year follow-up in 8 patients, 5 showed progressive cognitive decline. 
COMMENT. Similar to findings in adults, children and adolescents with MS have a high incidence of cognitive impairment and decline, especially affecting attention, memory and language. Cognitive dysfunction involving memory, language, and visual perception is included among initial symptoms of MS in a report of 5 childhood cases (Iannetti P et al, 1996; Progress in Pediatric Neurology III, PNB Publ, 1997;p553).