Unfortunately a friend of mine called last night to tell me her 11 yr old granddaughter was diagnosed with MS. After we cried together for a few minutes I told her I have heard about early onset ms but I don’t know anything about it. I told Debra I’d write a post so here I am.
The Webmd.com is a reliable source of information. They talk of how multiple sclerosis (MS) occurs most commonly in adults, it is increasingly being diagnosed in children and teenagers. Of the 400,000 diagnosed cases of MS in the U.S., 8,000 to 10,000 are in children up to 18 years old. Neurologists think there are probably many more children with MS that have not been diagnosed.
How MS Is Different in Children
Multiple sclerosis may manifest itself differently in children and adults. In children, it may begin after a period of neurological symptoms called acute disseminated encephalomyelitis (ADEM). For most children, the symptoms of ADEM — including headache, delirium, lethargy, coma, seizures, stiff neck, and fever — are temporary. But other children continue to have symptoms or experience additional symptoms that meet the criteria of MS.
MS is thought to progress more slowly in children than in adults; however, significant disability can occur at an earlier age in people whose MS begins in childhood or adolescence. The cognitive and psychological consequences of MS are likely greater in children and adolescents and may affect academic performance, self-image, and relationships with peers.
MS Symptoms in Children
The symptoms of MS in children are similar to those in adults and may include:
- Problems with bladder or bowel control
- Problems with walking
- Vision changes
- Muscle spasms
- Sensory changes, tingling, or numbness
In addition, children may experience seizures and lethargy that are not typical in adults.
The symptoms of MS can be erratic. They may be mild or severe. They may last a long time or just a short time.
MS Treatment in Children
Although there is no cure for MS, there are several treatments that can improve life for children with the disease. Treatment of MS in children as well as adults has three main goals: to treat attacks, to prevent future attacks, and to relieve symptoms.
Treating MS Attacks in Children
Corticosteroid medications are used to reduce inflammation in the brain and spinal cord during attacks of MS. The main corticosteroid used for MS attacks is Solu-medrol (methylprednisolone), which is given by IV once a day for three to five days. Sometimes doctors prescribe an oral corticosteroid called prednisone for a short time following the IV medication.
Although most children tolerate corticosteroids well, for some they cause side effects, including moodiness and behavior changes, increases in blood pressure and blood sugar, and stomach irritation. Doctors can treat these problems if necessary.
If corticosteroids alone don’t bring enough improvement, other treatments, including intravenous immunoglobulin (IVIG) and plasma exchange, are available to treat MS attacks.
Preventing Attacks of MS
Although corticosteroids can ease MS attacks, they do not prevent them. Doctors prescribe other types of drugs for that purpose. While decreasing the number of attacks, these drugs may also slow the disease’s progression to disability.
Preventing Attacks of MS continued…
Medications for MS are not approved by the FDA for treatment in patients younger than 18. However, doctors use immunomodulating drugs to treat children with MS, although dosing is modified.
Medications used for pediatric MS include:
- Avonex (interferon beta-1a)
- Betaseron (interferon beta-1b)
- Copaxone (glatiramer acetate)
- Rebif (interferon beta-1a)
Extensive studies have found these drugs to be effective and safe in adults with MS. Similar results have been seen in small studies of children with MS.
These medications are given by injection — either into the muscle or beneath the skin. Your child’s doctor or nurse can work with you to make the injections less troublesome. Teenagers may be able to give themselves the injections.
In addition, treatments may be recommended for specific symptoms related to MS, such as muscle spasm, fatigue, and depression.
As with all medications, they can cause side effects. The most common side effects with interferons are flu-like symptoms, such as fever, chills, muscle aches, and headaches, which start shortly after the injections. Your child’s doctor can minimize these and other side effects by starting the medication at a low dose, increasing it gradually, and giving other medications to relieve the side effects.
The most common side effect of Copaxone is redness and swelling at the injection site. If this occurs, techniques such as applying cold packs can help ease swelling.
Treating MS Symptoms
Symptoms such as fatigue, numbness or tingling, muscle stiffness, and depression may linger following an attack. Fortunately there are many treatments, including physical and occupational therapy, counseling, and medications, to help relieve these symptoms.
It is also important to remember that not every symptom a child with MS experiences can be attributed to MS. Children with MS get the same illnesses that other children get. Fevers or infections may worsen MS symptoms temporarily, but symptoms generally improve once the fever subsides or infection is controlled.