Multiple sclerosis happens most often in adults, but doctors are diagnosing more children and teenagers with the condition. Of the 400,000 diagnosed cases of MS in the U.S., 8,000 to 10,000 are in people younger than age 18. Neurologists think there are probably many more kids with MS that haven’t been diagnosed.
How MS Is Different in Children
The first signs of the disease are different for children. It might start after a child has a nerve disorder called acute disseminated encephalomyelitis (ADEM). Most of the time, the symptoms of ADEM -- including headache, confusion, coma, seizures, stiff neck, fever, and major lack of energy -- go away after a few weeks. But some children will keep having problems that are the same as MS.
Multiple sclerosis may get worse more slowly in children than in adults. But people who had the condition in childhood or adolescence can have physical disability at an earlier age. The disease also may cause greater challenges with thinking and emotions for children and teens, and may affect their schoolwork, self-image, and relationships with peers.
MS Symptoms in Children
The symptoms are similar to those in adults and may include:
- Problems with bladder or bowel control
- Problems with walking
- Vision changes
- Muscle spasms
- Sensory changes, tingling, or numbness
- Trouble remembering
Children also might have seizures and a total lack of energy that adults with the condition usually don’t have.
MS Treatment in Children
There is no cure, but many treatments can make life better for children with the disease. Multiple sclerosis treatment for people of all ages has three main goals: to treat attacks, to prevent future attacks, and to relieve symptoms.
Treatment for MS Attacks in Children
Corticosteroid medications reduce inflammation in the brain and spinal cord during attacks. The main one is methylprednisolone (Solu-medrol), which you get through an IV once a day for 3-5 days. Sometimes doctors prescribe a corticosteroid pill called prednisone for a short time after the IV medication.
Although most children can handle corticosteroids well, for some they cause side effects, including moodiness and behavior changes, increases in blood pressure and blood sugar, and upset stomach. Doctors can treat these problems if they come up.
If corticosteroids alone don’t help enough, your doctor may talk to you about other treatments, including intravenous immunoglobulin (IVIG) and plasma exchange.
Prevent MS Attacks
Corticosteroids can ease attacks, but they don’t prevent them. Doctors prescribe other types of drugs to do that. These meds reduce the number of attacks and keep the disease from getting worse quickly.
The FDA hasn’t approved MS medications for people younger than age 18. But doctors use some of them to treat children with the condition, but at a different dose than adults get.
Medications for children with MS include:
- Fingolimod (Gilenya)
- Glatiramer acetate (Copaxone)
- Interferon beta-1a (Avonex, Rebif)
- Interferon beta-1b (Betaseron)
- Natalizumab (Tysabri)
Your child will get these meds by injection -- either into the muscle or beneath the skin. The doctor or nurse can work with you on how to make them easier for your child. Teenagers may be able to give themselves the shots.
Scientists haven’t done as much research on how these drugs affect children as they have for adults. But the results of small studies have shown that they work well and are safe for kids.
Doctors can also treat specific symptoms related to MS, such as muscle spasms, fatigue, and depression.
Just like any medication, these can cause side effects. The most common ones with interferons are flu-like symptoms, such as fever, chills, muscle aches, and headaches, which start shortly after someone gets an injection. Your child’s doctor can ease side effects by giving a low dose of the drug at first and increasing it gradually. There are also other medications to relieve some side effects.
The most common side effect of Copaxone is redness and swelling at the spot where your child gets the shot. Cold packs can help with those problems.
Treatment for MS Symptoms
Symptoms such as fatigue, numbness or tingling, muscle stiffness, and depression may not go away entirely after an attack. But there are many treatments to help relieve them, including physical and occupational therapy, counseling, and medications.
Also, not every symptom your child might have is a result of the disease. Children with MS get the same illnesses other kids get. Fevers or infections may make MS symptoms worse for a little while, but they usually get better once the fever goes down or an infection is under control.