What Do We Know About Pediatric MS?: A HealthCentral Explainer
The number of children being diagnosed with multiple sclerosis (MS) appears to have increased during the past decade, but scientists remain uncertain whether the numbers reflect an increasing prevalence of MS itself.
One possible explanation is that a growing body of research on triggers for children developing MS is making doctors better able to make accurate diagnoses.
Pediatric MS—a chronic, autoimmune disease that affects the central nervous system (CNS) of people under the age of 18—affects about 3 to 5 percent of the 2.3 million people living with the condition worldwide. The percentage is relatively small for two reasons; first, the onset of MS typically occurs between ages 20 and 50; and second, diagnoses of MS in children are more challenging than they are in adults.
Symptoms of MS vary from person to person and can include changes in sensation, muscle function and cognition. Because of the disease’s variations, no single test is able to diagnose MS across the board. Testing for MS includes neurological examinations, magnetic resonance imaging (MRI), evaluations of clinical history and numerous other diagnostic tests. The process can take years before an individual may receive a diagnosis of MS.
Symptoms and types of diagnostic tests are mostly similar in both pediatric MS and MS in adults. But, when it comes to pediatric MS, ruling out all other possible diagnoses is a time-consuming part of the process. There are various childhood disorders that have similar symptoms and characteristics as those associated with MS, making diagnosing MS in children even more complex than it is in adults. Acute disseminated encephalomyelitis (ADEM), for example, is more common among children and can sometimes be confused with MS.
Psychological and psychosocial impact
There is currently no cure for MS in children or adults. Treatments for both children and adults are similar, and medications can help control the disease or slow its progression. The effectiveness of medications varies from person to person, so patients should work with their doctor to find the best treatment for them.
Research has shown that MS may have a greater psychological or psychosocial impact on children than it has on adults. According to the Pediatric MS Center, MS may affect children’s self-image, mood and cognition. Family members of someone with pediatric MS can discuss psychological and psychosocial concerns with the child’s neurologist, who then may be able to communicate with a psychologist, social worker and school personnel for helpful assessments and treatment.
Triggers for children developing MS
In recent years, scientists have been conducting more research on potential causes for pediatric MS. Many studies have specifically focused on the relationship between bacteria in the gut and the development of MS, as both are related to the immune system.
What’s known as the “gut microbiome” refers to the trillions of “good” gut bacteria that assist in food digestion and help prevent disease-causing bacteria. Researchers have found that the gut microbiome and immune cells send messages between each other, which affects the entire immune system—including possibly the immune attack in the central nervous system which occurs in MS. By further investigating the link between the immune system and gut microbiome, researchers said they hope to find ways to make more accurate diagnoses and develop treatments for both preventing disease and for altering the gut’s immune system to help treat people who have MS.
Other areas of research
Along with the recent rise in pediatric MS diagnoses has been the growth of other areas of research into the disease. Some include:
- Other triggers for pediatric MS
- Immune system differences in children and adults
- Pediatric MS clinical trials
- Specific psychological/psychosocial effects of MS on children
- Environmental factors for developing pediatric MS
With growing research, children with MS, as well as their family members, can be hopeful that scientists continue to answer questions about the disease, which may lead to more effective treatments to help manage MS later on. Numerous resources also exist to provide education, support and other services to help empower children and families living with MS. Some recommended resources include the (NMSS) National Multiple Sclerosis Society, National Institutes of Health (NIH) and American Academy of Neurology (AAN).
Coetzee, Timothy, PhD. Telephone interview. 23 Dec. 2013.
"Guide for Psychologists." Pediatric MS Center, n.d. Web. 13 Jan. 2014. <http://www.pediatricmscenter.org/professionals/psychologists>.
King, Mary E. "A Gut Reaction to MS." Momentum Magazine Online. National Multiple Sclerosis Society, 2013. Web. 13 Jan. 2014.
MacAllister, WS, JR Boyd, NJ Holland, MC Milazzo, and LB Krupp. "The Psychosocial Consequences of Pediatric Multiple Sclerosis." National Center for Biotechnology Information. U.S. National Library of Medicine, 17 Apr. 2007. Web. 13 Jan. 2014.
Vargas-Lowy, David, MD, and Tanuja Chitnis, MD. "Pathogenesis of Pediatric Multiple Sclerosis." Journal of Child Neurology. SAGE Journals, Nov. 2012. Web. 13 Jan. 2014. <http://jcn.sagepub.com/content/27/11/1394.abstract>.