MS Can Be a Kids’ Disease, Too (Part 2)

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by Ed Tobias |

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MS and ADS

After I wrote about pediatric MS earlier this month, a reader commented: “I think it would behoove your editorship to follow up to address to audiences…symptoms that typify the early-age demographic.” That’s a good point. So, I drilled deeper into how MS is handled in people younger than 18 years old and found some very interesting information.

Pediatric MS diagnosis

To begin with, neurologists have a difficult time diagnosing MS in pediatric patients. One reason, according to information provided by the Cleveland Clinic, is that the symptoms generally associated with MS may overlap with other pediatric diseases, particularly acute disseminated encephalomyelitis or neuromyelitis optica. Also, MRI scans may not show enough T2 hyperintense areas to meet the criteria necessary for an MS diagnosis in an adult.

According to a study in Current Neurology and Neuroscience Reports, determining an MS diagnosis in a youngster typically takes longer than in an adult.

“The more atypical the case and the younger the child, the more consideration is necessary before making a diagnosis of MS,” the study says.

A look at a chart published by the National MS Society gives an idea of how complex the diagnostic process can be.

Greater disability earlier in the disease

Pediatric MS may lead to significant disability at a younger age, for example, while patients are students or young professionals, or when they want to start a family. An article published in the journal Pediatric Health, Medicine and Therapeutics reports that pediatric-onset MS (POMS) “is associated with a higher relapse rate, and results in irreversible disability on average 10 years earlier than adult-onset multiple sclerosis.” A review by the authors of 20 articles published in medical journals over many years shows that “manifestations of POMS include mental and physical fatigue, cognitive impairment, and depression.”

So, there’s a need for a rapid diagnosis and treatment. But just as a diagnosis is difficult, so, too, is treatment.

Pediatric MS treatment

Treating MS in a child or young adult can be difficult because doctors lack good information about the efficacy and safety of the disease-modifying therapies (DMTs) they’re prescribing for these young people. That’s because there haven’t been any clinical trials of DMTs that have been designed specifically for pediatric MS patients. “As a result,” Cleveland Clinic doctors say, “children are receiving adult therapies in an arbitrary manner and our understanding of pediatric treatment effect and tolerability is limited.”

The authors of the Pediatric Health, Medicine and Therapeutics article, however, feel that treatments need not be limited to DMTs. They write: “Participation in health behaviors, particularly physical activity, diet, and sleep, may have benefits for POMS. Nevertheless, there are currently no interventions targeting promotion of these behaviors and examining the benefits of managing the primary and secondary manifestations of POMS.”

The National MS Society has some very detailed POMS information on its website.

So what now?

Though pediatric patients may make up only 5 percent, or fewer, of multiple sclerosis patients, they’re the patients whose disease seems to progress the fastest. They also have the longest futures ahead of them. So, it would seem to be a good thing to give greater attention to POMS in order to give these young people a better chance at a future in which their MS is held in check. That includes researching the effects on POMS patients of the non-pharmaceutical activities mentioned earlier and designing studies of DMTs using pediatric subjects. Difficult? Sure, but worth the effort.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Janice avatar


POMS they should be working with more adults Have DMT's we use but due to the lack of testing the dose's hve to be cut from adult DMT's. Like the Tecfidera I take would have to cut in half for them ( under 13 years of age ) to instead of 480 mg a day ( 2 a day 240 mg ) they would have to take 1 a day to in hopes not damage things any farther. They are our future and we need to help them all we can. If they can In time ( won't happen in my life time ) cure MS for them then they could cure it for us and I see a plus there. I sounds like I want to use them as test Subs but no I just feel that its harder to Diagnose children then Adults and we should us it as a blessing ( I feel for the children with this because it is hell as an adult )

Joan Quilter avatar

Joan Quilter

I know, now, that my 40 year old daughter had pediatric MS, but 30+ years ago, the medical community didn't believe children could have MS. Finally, when her optic neuritis developed at age 20, she was diagnosed. I guess it's just as well because I wouldn't have approved her taking MS drugs meant for adults. Unfortunately, her childhood was taken up with doctor visits, etc. with many days away from school. There never was any diagnosis of any kind.

Alfonso avatar


And how does she developed? Is she ok? I'm sorry if I was such as inquiring but I have a kid diagnosed with MS.

Penina Scullion avatar

Penina Scullion

Alfonso, have you heard of Pediatric Multiple Sclerosis Alliance?

Please look up the group on FaceBook.
We have a closed/vetted support group only for parents or guardians from around the world of children diagnosed with MS.
I think this is the link

Penina Scullion
[email protected]

Penina Scullion avatar

Penina Scullion

You need to review your assertions about lack of testing of DMTs for POMS.

A few months ago, a 2 year study of Fingolimod (Gilenya) in Pediatric Multiple Sclerosis was presented at ECTRIMS 2017, and in December 2017 the US FDA granted breakthrough status to it.

Ed Tobias avatar

Ed Tobias

Hi Penina,

I missed this but I'm glad that the tide is turning regarding DMTs for POMS.

Thanks for bringing me, and those who are reading this, up to date.



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