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(MS—Child)

Definition

Multiple sclerosis (MS) is a chronic disease of the central nervous system. It causes injury to the myelin layer that covers nerve fibers in the brain, spinal cord, and optic nerves.

Nerve Fiber (Neuron)
Myelin Sheath Damage
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Causes

MS is thought to be caused by a problem with the body's immune system. The immune system attacks and damages the myelin. The reason why is not known.

Risk Factors

MS is more common in females. Other things that may raise a child's chance of MS are:

  • Having family members who have MS
  • Having faulty genes
  • Low levels of exposure to sunlight
  • Having low vitamin D levels
  • Obesity
  • Being around secondhand smoke
  • Exposure to Epstein-Barr virus
  • Having inflammation of the optic nerve

Symptoms

There are many types of MS. When it occurs during childhood, it usually is relapsing and remitting. This means that the symptoms reappear every few months or years, last for a few weeks or months, then go away again.

Symptoms can range from mild to severe and may include:

  • Numbness or tingling in the face or limbs
  • Problems seeing, such as blurred vision, double vision, and loss of vision
  • Eye pain
  • Feeling very tired
  • Lightheadedness
  • Muscle stiffness, spasms, or weakness
  • Poor coordination
  • Problems walking or with balance
  • Weakness in one or more limbs
  • Bladder problems, such as urgency and loss of control
  • Bowel problems, including constipation
  • Slurred speech
  • Problems swallowing
  • Memory problems, confusion, and difficulty concentrating or solving problems
  • Seizures

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done.

Blood tests may be done. If the results are not clear, the child will be referred to a doctor who treats problems of the nerves and nervous systems.

Images may be taken the brain and spinal cord. This can be done with an MRI scan .

A lumbar puncture may also be done. It will check for signs of MS in the fluid that protects the spinal cord and brain.

Treatment

There is no cure for MS. The goals of treatment are to:

  • Ease symptoms
  • Prevent flare-ups
  • Slow the disease

Medications

Medicines used to treat MS in children are:

  • Corticosteroids to ease inflammation and shorten flare-ups
  • Interferon beta to suppress the immune system
  • IV immunoglobulin to ease inflammation and prevent flare-ups

Plasma Exchange

Plasma exchange removes the proteins damaging the myelin from the blood. Fresh plasma is added to the blood during the procedure.

Other Treatments

A child with MS may also need to work with a:

  • Physical therapist
  • Speech/language therapist
  • Occupational therapist to help with daily living tasks
  • Psychologist or therapist to help with coping skills

Prevention

There are no guidelines to prevent MS.

RESOURCES

Multiple Sclerosis Association of America  http://www.msassociation.org 

National Multiple Sclerosis Society  http://www.nationalmssociety.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Multiple Sclerosis Society of Canada  http://www.mssociety.ca 

References

Multiple sclerosis. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Multiple%20Sclerosis.aspx. Accessed December 31, 2019.

Multiple sclerosis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/multiple-sclerosis-ms  . Updated September 5, 2019. Accessed December 31, 2019.

Pediatric MS. National Multiple Sclerosis Society website. Available at: http://www.nationalmssociety.org/What-is-MS/Who-Gets-MS/Pediatric-MS. Accessed December 31, 2019.

Zurawski J, Stankiewicz J. Multiple Sclerosis Re-Examined: Essential and Emerging Clinical Concepts. Am J Med. 2018 May;131(5):464-472.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 12/31/2019