Pediatric Multiple Sclerosis (In Children)
In about 3-5% of MS cases the symptoms started in childhood, under the age of 16. Children as young as 2 can develop MS, but majority are diagnosed over the age of 10. Occasionally people diagnosed as adults can trace their symptoms back to childhood. MS in children is exceptionally difficult to diagnose as the most common alternative condition is ADEM (acute demyelination encephalomyelitis) which has similar symptoms to MS. A series of MRI scans may be needed to distinguish between the two.
Over the age of 10, more girls than boys are effected by MS. Under the age of 10 the gender ratio is roughly equal. Relapsing Remitting MS is the most common kind of MS in children. Progressive forms of MS can develop but are rare. Children with RRMS may be treated with Disease Modifying Drug treatments such as Beta Inteferon and Glatiramer Acetate, and other drugs, although, they are not tested in children, these need to be prescribed off-license by an individual neurologist.
Children with MS may be treated by Pediatric Neurologists and by Pediatric Neurology Nurse Specialists or in an adult Neurology clinic. There are not many Pediatric Neurologists and even fewer who specialise in MS.
A study, the Pediatric UK Demyelinating Disease Longitudinal Study (PUDDLS), started in 2011 which will last 5 years, is looking at the natural history, predictors and outcomes of MS and similar conditions in childhood. This would give a better idea of who gets MS in childhood and possibly why, what the initial symptoms tend to be, and how the condition changes over time. The first results from this study suggests that around 125 children who experience MS symptoms in the UK each year, only a third will develop MS.
How does the diagnosis of MS in children and adults differ?
Currently the diagnostic criteria for children and adults are the same. Diagnostic tools include the medical history, neurological exam, (MRI) magnetic resonance imaging, visual evoked potentials, spinal tap/lumbar puncture and other tests to rule out other diagnoses. A challenge arises as other diseases has similar symptoms to MS. Also children are less likely to report their symptoms e.g. visual problems or difficulties with balance which could delay diagnoses.
How does treatment of MS differ in children and adults?
Desease Modifying Treatments, Avonex (interferon beta 1-b), Betaseron (interferon beta 1-b), Copaxone (glatiramer acetate), Rebif (interferon beta 1-a) and Extavia (interferon beta 1-b) have been proven to slow down the progression of MS and considered as first-line therapies in children and adults. Although controlled trails are done on children over 18 years of age, experts believe that it is safe for children. For children who does not respond to these medications, other drugs may be described, including Tysabri (natalizumab), which is considered a second-line therapy.
Recent Comments
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Thanks for sharing this! It breaks my heart that there are kids with symptoms that live with them every day but don't report their symptoms. Especially since treatments slow down the progression of MS!
This is so true that is why every bit of awareness helps.