Pediatric Multiple Sclerosis
Overview
Multiple sclerosis (MS) is an autoimmune disease that attacks myelin in the brain and spinal cord. Myelin is a substance that protects nerves and allows signals to move efficiently through them. When myelin is injured, signals slow down or distort, which causes a variety of symptoms. Though MS is more common in adults, about 10% of MS diagnoses are made in children.
Symptoms
- Blurry or double vision
- Bowel or bladder control problems
- Difficulty walking
- Dizziness
- Fatigue
- Numbness or tingling
- Problems with balance
- Spasticity
- Tremors
- Weakness in one or more parts of the body
Mood disorders and cognitive health issues, such as memory loss, are also common with pediatric MS, affecting up to 30% of patients.
Prevention
No way to prevent pediatric multiple sclerosis is known.
Risk Factors
- Exposure to the Epstein-Barr virus
- Family history of multiple sclerosis
- Smoking or exposure to secondhand smoke
- Vitamin D deficiency
Diagnosis
- Medical history and symptom review. Multiple sclerosis can be tricky to diagnose in children, because many medical conditions can cause similar symptoms. As a first step toward a diagnosis, your healthcare provider will conduct a thorough review of your child’s symptoms and obtain your family and personal medical history.
- Physical examination. Your medical provider will then conduct a complete physical exam, paying particular attention to the parts of your child’s body impacted by symptoms. This physical examination will include a neurologic examination.
- Additional tests. To confirm a diagnosis of pediatric MS and rule out other potential conditions, your child’s provider will recommend a full range of tests, including an MRI scan to look for optic neuritis (inflammation in the optic nerve), a spinal tap to analyze fluid around the spinal cord and an evoked potentials test to analyze how quickly signals move through the nerves in the brain.
Treatment
- Pediatric MS is known as a “relapsing-remitting course,” which means that symptoms will return and then subside. As a result, treatment isn’t curative, but it is designed to both manage symptoms and limit relapses.
- MS flare-ups are often accompanied by inflammation that damages myelin. This inflammation is commonly treated using intravenous and oral corticosteroids, which help to reduce inflammation and limit the length and severity of flare-ups.
- Plasma exchange, or plasmapheresis, is another method of treatment typically used if steroids are ineffective or cause life-impacting side effects. During this treatment, blood is removed from the body and disease-causing substances are filtered out. The blood cells are then returned to the body.
- Immunoglobulin, a medication made up of antibodies from healthy blood donors, may be administered intravenously to limit negative immune responses common with pediatric multiple sclerosis.
- Your child’s provider may also recommend treatment with a disease-modifying medication, either in an injectable, oral or infused form. These medications act in distinct ways, but all serve the purpose of modifying the effects that MS has on the body.
Follow-up Care
- Because no cure for MS exists, treatment and care for the condition are ongoing. Your child’s provider will recommend a specific care plan based on your child’s symptoms and overall health.
- Smoking is a known contributor to MS, so it’s important to limit exposure to cigarette smoke.
- Vitamin D deficiency has been linked with pediatric MS flare-ups, so it’s important to have vitamin D levels checked regularly and to take a vitamin D3 supplement as needed.
- Regular physical activity, plenty of quality sleep and a healthy diet are also important pieces of the puzzle when it comes to limiting MS flare-ups.