MS (Multiple Sclerosis) in Children

Although multiple
sclerosis (MS) occurs most commonly in adults, it is increasingly being
diagnosed in children and teenagers. Of the 400,000 diagnosed cases of MS in
the U.S., 8,000 to 10,000 are in children up to 18 years old. Neurologists
think there are probably many more children with MS that have not been
diagnosed.

How MS Is Different in Children

Multiple
sclerosis may manifest itself differently in children and adults. In children,
it may begin after a period of neurological symptoms called acute disseminated
encephalomyelitis (ADEM). For most children, the symptoms of ADEM — including headache,
delirium, lethargy, coma, seizures, stiff neck, and fever — are temporary. But other children continue to have
symptoms or experience additional symptoms that meet the criteria of MS.
MS is thought
to progress more slowly in children than in adults; however, significant
disability can occur at an earlier age in people whose MS begins in childhood
or adolescence. The cognitive and psychological consequences of MS are likely greater
in children and adolescents and may affect academic performance, self-image,
and relationships with peers.

MS Symptoms in Children

The symptoms of
MS in children are similar to those in adults and may include:

• Problems
  with bladder or bowel control
• Weakness
  
• Problems
  with walking
• Vision
  changes
• Muscle
  spasms
• Sensory
  changes, tingling, or numbness
• Tremors

In addition,
children may experience seizures and lethargy that are not typical in adults.
The symptoms of
MS can be erratic. They may be mild or severe. They may last a long time or
just a short time.

MS Treatment in Children

Although there
is no cure for MS, there are several treatments that can improve life for
children with the disease. Treatment of MS in children as well as adults has
three main goals: to treat attacks, to prevent future attacks, and to relieve
symptoms.

Treating MS Attacks in Children

Corticosteroid medications
are used to reduce inflammation in the brain
and spinal cord during attacks of MS. The main corticosteroid used for MS
attacks is Solu-medrol (methylprednisolone), which is given by IV once a day for
three to five days. Sometimes doctors prescribe an oral corticosteroid called prednisone for a short time following the IV medication.
Although most
children tolerate corticosteroids well, for some they cause side effects,
including moodiness and behavior changes, increases in blood pressure and blood sugar, and stomach irritation. Doctors can treat these problems if
necessary.
If
corticosteroids alone don’t bring enough improvement, other treatments,
including intravenous immunoglobulin (IVIG) and plasma exchange, are available
to treat MS attacks.

Preventing Attacks of MS

Although
corticosteroids can ease MS attacks, they do not prevent them. Doctors
prescribe other types of drugs for that purpose. While decreasing the number of
attacks, these drugs may also slow the disease’s progression to disability.