MS (Multiple Sclerosis) In Children: Causes, Signs & Treatment

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Multiple sclerosis or MS is an autoimmune disorder where the immune system attacks the myelin, an insulating sheath around the brain and spinal cord nerves. If MS in children occurs before the age of 16 years, it is called pediatric MS. Pediatric MS cases account for 4 to 5% of total MS cases.

Myelin aids in the movement of electrical impulses through the nerves. Hence any damage to it can slow the impulse movement (1). Most cases of pediatric MS are diagnosed after the age of ten years, the phase marked by vital years of education and active brain maturation (2) (3).

Read on to know about MS in children, including its symptoms, causes, and treatments.

Symptoms Of Multiple Sclerosis In Children And Teens

 The symptoms of MS vary from person to person as this condition can affect any part of the central nervous system (brain, spinal cord, and optic nerves).

Up to 99% of children with pediatric MS are known to have a relapsing-remitting MS, meaning the child might experience recurring attacks that cause new or worsening symptoms, followed by periods without new symptoms (3).

Some of the common symptoms of MS in children and teens are:

  • Fatigue
  • Weakness
  • Tingling sensation and numbness
  • Double vision and pain while moving the eye
  • Tremors
  • Seizures
  • Slurred speech
  • Balancing issues
  • Bowel and bladder problems
  • Depression and anxiety
  • Cognitive and memory problems
  • Stiffness of the joints (4)

Symptoms such as depression and anxiety are seen in 27% of children with MS (5), and 30% of children show cognitive impairment (6). These symptoms appear during the flare-ups and may last for a few weeks to years. A total of 15-20% of MS children have symptoms similar to that of acute disseminated encephalomyelitis (ADEM), such as headache, vomiting, and seizures (2).

Causes Of Multiple Sclerosis

The exact cause of MS is not known; however, researchers believe that it could be a combination of genetic and environmental factors. In children who have a genetic susceptibility, environmental factors act as triggers (7).

Genetics 

Monozygotic twins have a 25% chance of developing MS, while the risk rate of dizygotic twins developing it is 2-5%. Studies also found that certain human leukocyte antigen (HLA) genes are associated with an increased risk of early onset of MS (2).

Environmental factors

Environmental factors may also trigger the onset and flare-up of the symptoms of MS. Exposure to viral and bacterial pathogens such as Epstein Barr virus (EBV) is linked with MS. The prevalence of MS is higher in the northern latitudes, and studies have shown that children who immigrate to high-risk countries show the new countries’ risk rate rather than their original countries.

Low levels of vitamin D have also been identified as a risk factor for pediatric MS. However, further studies need to be done to understand the exact role of vitamin D. Passive smoking is also shown to increase the risk of MS by two times in children (2) (7).

Diagnosis Of Multiple Sclerosis 

As this condition occurs in a series of relapsing-remitting episodes, it could be challenging to diagnose it during the early stages. A clear diagnosis may not be possible at the time of the first flare-up as the relapsing period may not occur yet. Also, the large number of symptoms associated with the disease make diagnosis challenging.

As new attacks and relapses occur, your doctor may be able to diagnose MS. The following tests would help the doctor diagnose the disease in your child (4).

  • The doctor would inquire about your family’s health history and ask about your child’s symptoms.
  • A neurological exam may be performed to understand the extent of damage in the central nervous system.
  • An MRI scan may also be recommended to further understand the damage in the parts of the brain and spinal cord. It would also help you know if your child developed optic neuritis, an inflammation in the optic nerve between the brain and the eye.
  • A lumbar puncture to examine the cerebral fluid for the antibodies and proteins associated with MS may also be done.

Treatment For Multiple Sclerosis In Children And Teens

There is no permanent cure for MS, although your doctor may prescribe medications to reduce the symptoms’ severity during the flare-ups (4).

  • Steroids, commonly given through the IV route, are recommended for the acute treatment of symptoms of MS in children. However, long-term treatment with steroids may have some side-effects, such as irritability, difficulty in falling asleep, stomach issues, and high blood pressure and high blood sugar levels.
  • Intravenous immunoglobulins may help decrease the unwanted immune response that occurs in MS. The common side effects include headache, muscle and joint pains, and low-grade fever and risk of acquiring infections.
  • Plasma exchange may be recommended when the neurological symptoms are difficult to treat. In this process, the blood from the body is removed and washed to eliminate the disease-causing substances.

Home Care For MS

Apart from the medications, you could also make certain lifestyle changes to manage MS symptoms.

  • Studies have found that with simple changes in diet, you might be able to reduce the rate of relapses and their severity.

A study suggests that a diet rich in high saturated fat increases the risk of relapse in children, while intake of vegetables shows positive results (8).

Another study suggests that children whose iron intake is less are more susceptible to pediatric MS (9).

  • Make sure your child eats a healthy diet that includes foods rich in iron and vitamin D.
  • Keep track of your child’s weight, and encourage them to exercise regularly and get plenty of sleep.
  • Educate your child about the ill effects of smoking, and encourage them to avoid passive smoke.

Prognosis Of MS 

MS is rarely fatal; however, as MS is a progressive disease, it can affect your child’s quality of life. Constant follow-ups and medical care are recommended if your child is diagnosed with MS.

MS also significantly impacts your child’s mental health. Children may develop low self-esteem as they may not perform well at school. Due to the episodes of relapses, children may not have a social life or friends at school, which may further make them feel depressed.

MS in children is a type of autoimmune disorder that cannot be completely cured or prevented. However, being a progressive disease, timely diagnosis and treatment is important and may help cope with the condition. If you notice any signs of MS in your children, such as fatigue, difficulty in talking, seizures, or memory problems, you need to consult your child’s doctor immediately. Support them through their condition to help them stay strong both physically and mentally by making the necessary changes to their lifestyle.

Key Pointers

  • Multiple sclerosis (MS) is a condition that damages nerve fibers of the central nervous system due to an autoimmune reaction.
  • Pediatric MS is usually encountered in children and teens below 16 years, and symptoms may include fatigue, vision problems, balancing difficulties, seizures, and cognitive issues.
  • Multiple sclerosis cannot be completely cured, but the symptoms may be managed with steroids, intravenous immunoglobulins, or plasma exchange.
  • Maintaining a healthy weight and having a diet rich in iron and vitamin D may prevent relapses.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Myelin; National Institutes of Health
2. Soroor Inaloo and Saideh Haghbin; Multiple Sclerosis in Children; Iranian Journal of Child Neurology (2013).
3. Amy Waldman et al.; Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research; HHS Author Manuscripts (2015).
4. Pediatric Multiple Sclerosis; Children’s Hospital of Philadelphia
5. Maria Skokou, Evanthia Soubasi, and Philippos Gourzis; Depression in Multiple Sclerosis: A Review of Assessment and Treatment Approaches in Adult and Pediatric Populations; ISRN Neurology (2012).
6. Laura Julian et al.; Cognitive Impairment Occurs in Children and Adolescents With Multiple Sclerosis: Results From a United States Network; HHS Author Manuscripts (2013).
7. Emmanuelle Waubant et al.; Environmental and genetic risk factors for MS: an integrated review; Annals of Clinical and Translational Neurology (2019).
8. Saeedeh Azary et al.; Contribution of dietary intake to relapse rate in early paediatric multiple sclerosis; Journal of Neurology, Neurosurgery, and Psychiatry (2018).
9. Julia Pakpoor et al.; Dietary factors and pediatric multiple sclerosis: A case-control study; Multiple Sclerosis (Houndmills, Basingstoke, England) (2018).
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Dr. Aarti R. Motiani

(MD, DNB)
Dr. Aarti Motiani is a child specialist with a decade of experience in patient care.  She has special interest in nutrition, immunization, and development of kids. Dr. Motiani treats kids with minimal medicine and believes in parents counselling for every behavior of the child.

Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more

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