Pediatric MS

Although MS occurs most commonly in adults, it is also diagnosed in children and adolescents. Estimates suggest that 8,000-10,000 children (up to 18 years old) in the United States have MS, and another 10,000-15,000 have experienced at least one symptom suggestive of MS. Studies suggest that two to five percent of all people with MS have a history of symptom onset before age 18.

Diagnosing MS in children is more challenging than in adults due to the frequency of other childhood disorders with similar symptoms and characteristics. Pediatricians may not be familiar with MS because they are not expecting to see it in children. Children with MS benefit from comprehensive care through multidisciplinary teams that include pediatric and adult MS experts.

Once diagnosed, almost all children are considered to have relapsing-remitting MS, with most symptoms of MS similar to those seen in adults. There are, however, symptoms experienced by children that are not typical in adults, such as seizures and mental status changes (lethargy).

• Children often experience more frequent relapses than adults with early MS.
• Increasing evidence suggests a slower disease course in children with MS, but significant disability can accumulate at an earlier age compared to individuals with adult onset MS.

Psychosocial consequences of MS in children and adolescents may affect academic performance, family relations, and specific adolescent issues including self-image and relationships with peers. An evaluation by a trained professional can help determine appropriate interventions, and resources are  available to help you navigate the school system through the Pediatric MS Support Group.

Studies have shown that the U.S. Food and Drug Administration (FDA)-approved self-injectable disease-modifying therapies developed for adults are also safe and well tolerated in children. At present, these medications are used “off-label” in children. Large clinical trials are needed to assess treatment efficacy for the disease-modifying therapies in children, adolescents and teenagers.

• Small studies suggest that Tysabri® (natalizumab) is safe in children. It is used primarily in children who have not responded to other treatments.
• There are no current data available on safety or tolerability of the oral medications in the pediatric population. 

The International Pediatric MS Study Group has written a series of articles, highlighting the advances, unanswered questions and challenges in diagnosing and treating MS in children. These articles have been published in a supplement to the journal Neurology. A publication from the Multiple Sclerosis International Federation (MSIF) summarizes the key points from each of these articles.