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Multiple sclerosis (MS) is a chronic inflammatory disease that attacks the central nervous system, including the spinal chord, optic nerves, and brain. MS most frequently occurs in adults, but it can also be diagnosed in children and teens. It is estimated that at least 8,000 children in the United States have multiple sclerosis, but pediatric MS is more difficult to diagnose due to the common occurrence of other childhood disorders with similar symptoms. 

Up to five percent of people diagnosed with MS have a history of symptoms before age 18. Initial symptoms have been documented in children as early as 13 months old. Some symptoms that could be suggestive of MS include:

• Fatigue
• Numbness or tingling
• Visual blurring or double vision
• Bladder and/or bowel dysfunction
• Difficulty walking
• Balance and coordination problems
• Dizziness and vertigo
• Emotional changes
• Depression
• Spasticity
• Pain

In children, seizures and changes in mental status (such as lethargy) are more common than in adults. Building awareness of possible symptoms of MS is important, as many pediatricians may not be familiar with the disease since it is so rarely encountered in children.

Diagnosing MS in anyone is not easy because there is no single test and no standard set of symptoms. Doctors must find evidence of two episodes of MS activity in the patient’s central nervous system, and both must have occurred at different times in order for a diagnosis to be made. Multiple sclerosis is especially difficult to pinpoint because the doctor must rule out all other possible explanations for symptoms that could have been caused by other disorders. Doctors must do a differential diagnosis to take such conditions as infections, genetic or metabolic disorders, inflammatory disorders, nutritional deficiencies, and endocrine disorders into account.

Due to advances in technology and raised awareness of pediatric MS among neurologists and pediatricians, the number of children diagnosed with MS continues to grow. Most cases of MS in children are of the relapsing-remitting variety, where patients have attacks of symptoms, with or without recovery, but there is no worsening between attacks. Significant disability can accumulate at an earlier age in children compared to adults with MS, but more and more evidence suggests a slower disease course in pediatric cases.

It is critical to better understand pediatric MS so that treatments for children can be systematically studied, tested, and approved. In 2006, the National MS Society established a first-of-its-kind network of six Pediatric MS Centers of Excellence. Through a peer review process, these centers were selected on the basis of having multidisciplinary teams of adult and child specialists and ties to an adult MS Center. Consequences of MS in children and teens sometimes manifest in academic performance, family relations, and issues of self-confidence, self-esteem and relationships with peers. These centers also evaluate and address these psychosocial issues and provide support for families, regardless of their ability to pay or proximity to one of the centers.

Source: http://www.nationalmssociety.org/