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.
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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 1 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 of 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.
Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD Last Updated: 6/10/2020