Patient education: Multiple sclerosis in children (The Basics)

What is multiple sclerosis in children? — Multiple sclerosis in children is a disease that can cause vision problems, movement problems, and other symptoms. It happens when the body's infection-fighting system (called the "immune system") attacks and damages nerve cells (figure 1). When it attacks the body's own cells, this is called an "autoimmune response."

Many people call multiple sclerosis "MS."

There are several types of MS. Most children have a type called "relapsing-remitting MS." In this type, the MS symptoms come and go. When a person has new or worse symptoms than usual, this is called an attack or a "relapse." An attack can last several days or weeks. It usually goes away slowly. Between attacks, a person might feel normal.

What are the symptoms of MS in children? — The symptoms include:

●Vision problems, eye pain, and odd eye movements

●Feeling dizzy or off-balance – This can cause the child to fall.

●Weakness and stiffness in the face or an arm or leg – This usually affects just 1 side of the body.

●Problems controlling the bowels or bladder

●Feeling very tired, depressed, or less active than usual

●Headache, seizures, or altered consciousness – These are less common symptoms of MS in children, but they sometimes happen. Seizures are waves of abnormal electrical activity in the brain. During a seizure, a child might have sudden jerking or twitching movements. "Altered consciousness" might involve confusion, changes in mood, trouble staying awake, or seeming "out of it."

A child with MS might not have all of these symptoms. Some children have just 1 or a few symptoms. The symptoms can come and go at different times.

Should my child see a doctor or nurse? — Your child should see a doctor or nurse right away if they have any of the symptoms above and you do not know the cause.

Is there a test for MS in children? — Yes and no. The doctor will ask about your child's symptoms and do an exam. Doctors can order tests, but the tests might not show MS right away. With MS, symptoms and test results can change with time. Sometimes, doctors have to test a child again, or do more tests, before they are sure the child has MS.

If the doctor thinks your child might have MS, they might order additional tests. These include:

●MRI – This imaging test uses powerful magnets to create pictures of the inside of the body. To look for MS, doctors usually do an MRI of the brain and sometimes of the spinal cord. The MRI can show if there are signs of MS in the brain or spinal cord.

●A lumbar puncture (sometimes called a "spinal tap") – During this procedure, a doctor puts a thin needle into the lower back and removes a small amount of spinal fluid. Then, they check the fluid for signs of MS.

●A test called "evoked potentials" or "evoked responses" – This is a way for the doctor to look at the electrical signals in your child's brain. It involves sticking small "electrodes" to the skin. Then, your child looks at changing light patterns while the doctor measures the nerve signals in their brain.

Many other conditions can cause symptoms similar to MS in children. The doctor can order other tests to look for these conditions.

How is MS in children treated? — Doctors cannot cure MS in children or adults. But they can give medicines to treat the attacks. These include:

●Steroid medicines – These can make attacks shorter. These are not the same as the steroids some athletes take illegally.

●"Disease-modifying therapy" – These medicines lower the chance of having an MS attack. They do not cure MS. Some of these medicines come as injections (shots). Many children learn to give themselves the shots. Some medicines for MS come as pills or capsules to swallow. Others are given through a thin tube that goes into a vein, called an "IV." Talk to your doctor about which kind of medicine is best for your child.

Doctors can also treat symptoms of MS. Many people with MS, including children, get very tired. They might also feel depressed, have problems thinking, or have muscle spasms. If your child has any symptoms, tell the doctor or nurse, even if you do not think they have anything to do with MS. The doctor or nurse can offer your child special treatments for those symptoms.

What will my child's life be like? — If you just learned your child has MS, try to stay positive. In most children, MS is a very slow disease.

The medicines used to treat MS are often very good at keeping attacks from happening. Some people with relapsing-remitting MS go many months or years without having attacks. Even so, doctors cannot really tell how fast MS will get worse. Some children do very well. Other children lose the ability to do some things over years or decades.

More on this topic

Patient education: Multiple sclerosis in adults (The Basics)
Patient education: Weakness (The Basics)
Patient education: Meningitis in children (The Basics)

Patient education: Meningitis in children (Beyond the Basics)