Adolescents and Children Get Multiple Sclerosis, Too
Doctors have been diagnosing increasing numbers of adolescents and even younger children with multiple sclerosis (MS). The typical victim is a woman in her 40s, but it is thought that around 10,000 victims under the age of 18 have been diagnosed with MS in the United States alone. Some neurologists believe that the disease is under-diagnosed in children, and the true incidence is much higher.
Pediatric Multiple Sclerosis is Different
Although there are many similarities between adult-onset and childhood-onset MS, there are also many differences. The main difference from adult MS is the apparent trigger. In most adults, there is no apparent trigger of the disease. However, in children, often the disease arises after an episode of acute disseminated encephalomyelitis (ADEM). ADEM is caused by an abnormal immune system reaction to a viral or bacterial infection. ADEM symptoms include headache, fever, neck stiffness, confusion, seizures, and sometimes coma. Most affected children recover completely after a few weeks, but others go on to develop MS. Other ways in which childhood onset MS differs from the adult form include:
- Slower rate of progression
- Greater impact on cognition and emotions
- Lack of energy and lethargy
Symptoms of Pediatric Multiple Sclerosis
Other than the lack of energy and possibility of seizures, the other symptoms of childhood MS are similar to that of adults. These include intermittent attacks of muscle spasms, sensory changes, difficulty in walking, problems with bladder control, weakness, and tremors. Episodes come and go in most children and adults with MS (relapsing-remitting). After a period of time (decades, in most cases), the victim enters a phase where the problems become continuous, and gradually get worse (secondary progressive). Cases of childhood onset appear to progress much slower than adult onset cases, but due to the early age of onset, permanent physical disability may begin to affect childhood onset victims at a much younger age than adult onset victims.
Problems Unique to Pediatric Multiple Sclerosis
Children and adolescents affected by MS often struggle with schoolwork, suffer from a poor self-image, and have difficulty established relationships with peers. Adolescence is a time of great change, and even healthy teenagers can struggle. Adolescents afflicted with the lack of energy and intermittent attacks caused by MS can have a particularly rough time.
Although there is no cure for MS, there are treatments that help with the attacks and slow disease progression. During relapsing episodes, the standard treatment is corticosteriods, which interrupt and shorten the episode. Intravenous immunoglobulins and/or plasma exchange can also be used to treat relapsing episodes. Three different medications have been approved by the FDA to help prevent MS relapses and to slow down the rate of progression of the disease. These medications have not been approved for use in children, but many doctors prescribe them off-label to childhood victims of MS. They are:
Unfortunately, these medications have to be administered via injection. However, parents can be taught how to give the injections, and older children can learn to inject themselves. In addition, doctors have many specific medications to help ease specific problems experienced by patients with MS, such as fatigue and muscle spasms. A diagnosis of childhood onset MS is not a death sentence, and most victims go on to lead rewarding, independent lives.