Pediatric multiple sclerosis (MS), also called juvenile MS, refers to early-onset multiple sclerosis that affects children as young as age 4 or 5.
It is estimated that around 10,000 children worldwide have pediatric MS. Exact numbers are difficult to ascertain, however, as the symptoms of pediatric MS overlap with those of several other conditions.
Symptoms of pediatric MS
Children with MS exclusively have relapsing-remitting multiple sclerosis (RRMS). That is, they have symptomatic periods (relapse) followed by almost complete recovery (remission), in which they have only a few symptoms or none at all. These symptoms are similar to those seen in adults and may include fatigue, numbness or tingling, muscle spasms or weakness, walking difficulties, bladder or bowel problems, vision problems, and emotional changes.
While children with MS tend to have more relapses than adults, they also tend to recover more quickly during remission. Pediatric MS seems to affect girls more than boys, which may indicate that hormones modify disease progression.
Diagnosis of pediatric MS
Diagnosing pediatric MS is challenging because there are few criteria to diagnose the disease in children. Moreover, the symptoms of pediatric MS may be confused with those of acute disseminated encephalomyelitis or other pediatric diseases.
Children with MS also have fewer brain lesions visible in magnetic resonance imaging (MRI) scans, making diagnosis harder.
In general, a child must have two discrete demyelinating events — these include inflammation, vision loss, tremors, and muscle spasms — to be diagnosed with pediatric MS.
Treatment of pediatric MS
Very few controlled clinical trials have been carried out in children with MS to test disease-modifying therapies because of the limited number of patients.
Children with MS are generally treated with adult therapies such as interferon beta and glatiramer acetate but the tolerability and effect of these treatments in juvenile patients are not well-known.
Gilenya (fingolimod) is one MS treatment that has been tested and approved in patients with MS, ages 10 and older.
Last updated: Jan. 8, 2020
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