Multiple sclerosis in children

When a problem with the immune system leads to multiple sclerosis, it can affect the nervous system and cause problems throughout the body.

The experienced pediatric neurologists at Advocate Children’s Hospital offer the latest treatments to manage symptoms and help children live a full life. With medications to prevent relapses and rehabilitation therapy to promote active lifestyles, we’re dedicated to helping your child for the long term.

What is multiple sclerosis?

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (the brain, spinal cord and their nerves). With MS, the body’s immune system attacks the protective membrane surrounding nerves called the myelin sheath. Damage to this sheath interferes with nerve signals between the brain and the rest of the body.

Pediatric MS, which occurs in children and teens, is rare. As with adult MS, the condition is chronic (long term) and gets worse over time. MS in children and teens is usually have the relapsing-remitting type, which means that symptoms come and go. MS can affect movement, vision, and other body systems, depending on where the nerve damage happens.

What causes multiple sclerosis in children?

The causes of MS in children and adults are unknown. Some factors that can increase the risk of getting MS include:

• Exposure to the Epstein-Barr virus
• Exposure to toxins such as secondhand smoke or pesticides
• Family history such as a parent or sibling with MS
• Low levels of vitamin D
• Other autoimmune disorders such as inflammatory bowel disease or type 1 diabetes

Multiple sclerosis symptoms and signs

The symptoms of pediatric MS in children vary from day to day and person to person. Depending on which nerves are affected, MS can cause symptoms and signs in various body systems.

Muscle symptoms

• Difficulty with balance or walking
• Eye problems such as pain with eye movement and blurry or double vision
• Pain with muscle spasms
• Problems with bladder or bowel control (incontinence)
• Tremor (shaking) or spasticity (uncontrollable muscle contractions)
• Weakness, numbness or tingling, sometimes on only one side of the body

Emotional and cognitive symptoms

• Anxiety, depression and panic disorder
• Difficulty with concentration, attention and memory
• Impaired executive functions such as planning and decision-making

Symptoms more common in children

• Extreme fatigue
• Seizures
• Vision changes

Multiple sclerosis diagnosis

Pediatric MS is often difficult to diagnose since the condition is rare and its symptoms resemble those of common childhood diseases. It’s important to see doctors with experience caring for neuromuscular diseases. Our Pediatric Neuromuscular Disorder Clinic brings together pediatric specialists in multiple medical fields to offer your family a team approach to care.

Our neurologists ask about your child’s symptoms and medical history, and complete physical and neurological exams. We can often confirm a diagnosis using this information and magnetic resonance imaging (MRI).

This painless scan creates detailed images of the brain, spinal cord and eyes, showing lesions (damage) to nerves in those areas. We offer fast MRI, with technology that corrects for movement so your child doesn’t need anesthesia.

Additional MS tests

Sometimes, we may need more testing to confirm MS and rule out other conditions. Find out more about what to expect from our evaluation process.

Additional recommended tests for MS in children include:

• Lumbar puncture: We take a small sample of cerebrospinal fluid, which surrounds the brain and spinal cord, to look for signs of MS.
• Evoked potential (EP) tests: These painless tests measure electrical activity in the brain and spinal cord to show how fast signals move through nerves. EP tests can find damage along nerve pathways that a neurological exam or MRI can’t detect.

Pediatric multiple sclerosis treatment

While MS has no cure, treatment helps relieve symptoms during flare-ups and can slow the progression of the disease. Specialists in our neurology program work together to design a customized treatment plan. We work closely with you and your child to adjust things as needed over the long term.

Treatments to manage symptoms

We can treat symptoms and reduce the harmful immune response caused by MS with:

• Corticosteroids: Medical steroids reduce inflammation (pain and swelling), with your child receiving them intravenously (IV, through a vein) or by mouth.
• Medications: A wide range of medications can help improve your child’s quality of life by managing pain, muscle spasms or stiffness, fatigue and other symptoms.
• Plasma exchange: We replace the plasma in your child’s blood to remove immune cells that are attacking the myelin sheath.
• Intravenous immunoglobulin (IVIG): This treatment is a blood product that contains antibodies from healthy donors. IVIG can suppress the harmful immune reaction to myelin, but it isn’t usually the first treatment for MS.
• Rehabilitation therapy: Physical and occupational therapy can help your child feel better and stay active. Our therapists guide your child through exercises to improve strength, flexibility and skills so they can keep doing the activities they love. Read more about our inpatient and outpatient rehabilitation and development program.

Medications to slow multiple sclerosis

Several medications can slow the progression of MS and help prevent relapses. These drugs work in various ways to reduce the harmful immune attacks on the myelin sheath. While most have federal approval to treat only adults, doctors can use them to treat children, too.

In 2018, fingolimod, the first treatment for children and teens with MS, received approval from the U.S. Food and Drug Administration. Fingolimod (Gilenya®) was already approved in 2010 for adults and helps prevent relapses.