Multiple Sclerosis in Children

By Brian P. Dunleavy and Ana Sandoiu, MA / Updated on April 3, 2025Medically

Reviewed by Jason Paul Chua, MD, PhD

Multiple sclerosis (MS) is a condition of the central nervous system (CNS) that can cause muscle weakness and sensory symptoms. It’s usually diagnosed in adults, but children can develop MS too. According to the National Multiple Sclerosis Society (NMSS), fewer than 5,000 children and teens are living with pediatric multiple sclerosis in the United States, and fewer than 10,000 have it worldwide.

As with adults, there’s no way to prevent or cure MS in children. However, many treatments are available to address symptoms for children with the condition. Although MS is a chronic and progressive disease, it isn’t fatal.

Children with MS can maintain a good quality of life well into adulthood by treating and managing the symptoms and associated challenges. 

Here’s what you need to know to ensure proper diagnosis and treatment if your child has MS.

Types of Pediatric MS

The three most common types of MS are:

• Relapsing-Remitting MS (RRMS), in which people experience occasional flare-ups of new or worse symptoms followed by periods of remission, or no symptoms.
• Secondary-Progressive MS (SPMS) comes after the RRMS stage. In this type, the symptoms and resulting disability gradually progress over time.
• Primary-Progressive MS (PPMS), in which symptoms are progressive from the onset of the disease.

The vast majority (up to 98 percent) of children with MS have the relapsing-remitting form of the condition; a very small proportion of children develop the primary-progressive type.

Signs and Symptoms of Pediatric MS

In general, most of the symptoms of MS in children are the same as those experienced by adults, namely:

• Fatigue
• Muscle weakness, tingling, and numbness
• Vision problems (including double vision) or vision loss
• Difficulty maintaining balance
• Problems walking
• Muscle tremors or spasticity
• Bowel or bladder control problems
• Slurred speech
• Problems with thinking and memory

Relapses and Other Signs of Pediatric MS

“Some studies have suggested that children may have up to three times as many relapses as adults early on in the course of their MS,” says E. Ann Yeh, MD, director of the pediatric neuroinflammatory disorders program at the Hospital for Sick Children in Toronto, and a professor of pediatric medicine at the University of Toronto.

As a result, children and adolescents with MS may face challenges in academic performance and family relationships, and the condition can further complicate issues most young people deal with, like poor self-image and making friends.

Although research indicates that MS progresses more slowly in children than in adults, younger people with the condition are more likely to have significant disability earlier after a diagnosis than those with adult-onset MS.

“While it’s true kids generally have more relapses than adults, and they also typically show more inflammation on MRI, as a group the kids recover more fully from relapses than adults,” says Lauren B. Krupp, MD, the director of the NYU Langone Multiple Sclerosis Comprehensive Care Center in New York City.

“As a group, many kids with MS do extremely well. However, children with MS aging into adulthood will reach any disability level generally at a younger age than those with adult-onset MS, so those with pediatric-onset MS may need to use a cane or other assistive devices at a younger age.”

Causes and Risk Factors of Pediatric MS

Researchers don’t yet know what causes pediatric MS. The potential causes and mechanisms are being studied in clinical trials. So far, existing research points to some potential environmental factors that may raise the risk of MS in children, including:

• Low sunlight exposure or low vitamin D levels
• Early exposure to Epstein-Barr virus (EBV)
• Exposure to secondhand smoke
• Exposure to pesticides 
• Living in an area with poor air quality or pollutants
• After puberty, sex hormones may play a role, with girls being 2 times more likely to develop pediatric MS than boys
• Obesity

Genes can also play a role. For example, researchers have identified the HLA allele (or gene variation) that raises the risk of pediatric MS. A combination of genetic predisposition and exposure to certain environmental factors is likely what drives MS.

How Is Pediatric MS Diagnosed?

Just like in adults, diagnosing MS in children is a complex process involving a discussion of symptoms and when they occurred, a basic neurological exam, and tests both to look for signs of MS and to rule out other things such as infection, vitamin deficiencies, and other conditions that mimic MS.

Tests that a doctor may order include:

• Blood tests
• An MRI scan
• A spinal tap, also called a lumbar puncture
• An evoked potentials test, which is a noninvasive procedure where tiny electrodes are attached to the head while your child receives visual or auditory stimuli

The Challenges of Diagnosing Pediatric MS

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