PATIENTS AND METHODS

Multiple sclerosis is the most common neurologic disease of young adults and already occurs in 2 % to 6 % of cases before 16 years of age.1 Oligodendrocytes are the primary target of the inflamma-tory process. However, recent evidence from histopathologic and neuroimaging studies suggests that axonal injury also contributes to the disease process and occurs in the early stages of the disease.2 Markers of axonal injury, such as tau, a neuronal cytoskeletal pro-tein, and phospho-tau protein, can be measured in cerebrospinal fluid.3 Elevated tau protein levels have been predominantly found in adults with multiple sclerosis and acute relapses.4,5 Another surrogate marker of central nervous system injury might be S-100B protein, which is primarily found in glial cells and has been shown to be elevated in adult patients with multi-ple sclerosis.6 To find further evidence that markers of axonal injury and glial activation are elevated in the cerebrospinal fluid of children with multiple sclerosis, we analyzed the cerebrospinal fluid for the presence of tau, phospho-tau, and S-100B proteins in these patients and various control groups