Pediatric Multiple Sclerosis

What Are the Types of Pediatric MS?

There are different types of MS:

• Relapsing-remitting MS (RRMS): RRMS is the most common type in children. It causes attacks or flares of symptoms (called relapses) followed by periods without symptoms (called remission). The MS symptoms don’t worsen in between attacks. Children with RRMS tend to have more frequent relapses. 
• Primary progressive MS (PPMS): With PPMS, MS symptoms worsen over time.
• Secondary progressive MS (SPMS): Children with RRMS often eventually develop SPMS. Nerve damage and symptoms worsen, leading to fewer periods of remission. 

What Causes Multiple Sclerosis in Children?

Pediatric MS is a type of pediatric neuroimmune disorder, which means it affects your child’s immune system and nervous system. The immune system is supposed to fight germs and keep your child healthy. When a child has MS, the immune system overreacts to things that aren’t actually harmful. Immune cells attack the protective layer that surrounds nerves (myelin), leading to a process called demyelination. Often, experts aren’t sure what triggers this process. 

During demyelination:

• The immune system attacks and damages myelin sheaths that surround and protect nerve cells (neurons) in the brain and spinal cord 
• Lesions or plaques of scars form on the damaged nerve cells 
• Scarring affects how well nerve cells can send messages to the body to perform various functions

What Are Risk Factors for Pediatric MS?

Anyone can develop MS. Certain genetic or environmental factors may increase a child’s risk. These risk factors include:

• Having a parent or sibling with MS 
• Low vitamin D levels
• Increased body mass index (BMI)
• Smoking
• Viruses, such as those that cause mononucleosis.

What Are the Signs and Symptoms of Pediatric MS? 

Signs of pediatric MS typically appear when a child is between 13 and 16 years old.

Common MS Symptoms in Children 

Common MS symptoms in children include:

• Balance issues or difficulty walking
• Behavioral problems or personality changes, such as irritability or sadness
• Difficulty concentrating or remembering things
• Extreme fatigue
• Muscle weakness, numbness, or pins-and-needles sensation 
• Pee and/or poop accidents 
• Tremors
• Vision problems 

How Is Pediatric MS Diagnosed?

Pediatric neuroimmunologists diagnose and treat MS in children. These pediatric neurologists specialize in immune system and nervous system issues. Pediatric MS is uncommon. Lurie Children’s doctors diagnose and manage the care of many children with MS, giving our team the expertise to make a fast, accurate diagnosis. 

In addition to comprehensive physical and neurological exams, your child may get one or more of these diagnostic tests:

• Blood tests to check for immune markers that can indicate autoimmune disease or inflammation
• Neuroimaging tests, such as brain and spinal cord MRIs, to look for lesions on the brain, spinal cord and nerves 
• Lumbar puncture (spinal tap) to check cerebrospinal (brain and spinal cord) fluid for proteins (antibodies) associated with MS
• Visual screenings and eye exams to check for optic nerve damage and vision problems

How Is Pediatric MS Treated?

MS treatments can ease symptoms, allowing your child to enjoy a full, active life. Treatments depend on the type of MS and symptoms. Lurie Children’s interdisciplinary team develops a personalized care plan that addresses your child’s unique needs.

Medications for Children With MS 

These medications can help children who have MS:

• Disease-modifying therapies (DMT), including oral, injectable and IV medications, to slow disease progression and prevent relapses
• Steroid medications to minimize inflammation, ease symptoms and shorten a relapse
• Therapeutic plasma exchange (plasmapheresis) to treat a severe relapse that doesn’t respond to other treatments
• Vitamin D supplements to boost vitamin D levels

Therapeutic Treatments for Children With MS

Lurie Children’s comprehensive therapies for children with MS include:

• Rehabilitative services, such as physical therapy and occupational therapy, to improve your child’s ability to get around and manage daily tasks
• Orthotic treatments to aid movement and stability
• Speech therapy to address MS-related speech impairments or feeding and swallowing problems 
• Clinical nutrition services to ensure your child gets enough vitamin D and other nutrients in their diet to support healthy muscles, nerves and bones
• Vision services (ophthalmology) to manage optic neuritis or other eye problems
• Inpatient rehabilitation at the Shirley Ryan AbilityLab for children who need more intensive rehabilitative services

What Is Lurie Children’s Approach to Caring for Children With MS?

An interdisciplinary team of specialists at Lurie Children’s Neuroimmunology Clinic provides high-level care for children with MS. Your child receives care at one of the nation’s best hospitals for pediatric neurology and neurosurgery, as rated by U.S. News & World Report. 

Our comprehensive pediatric MS services include:

• Specialized neuroimmune focus: Lurie Children’s neuroimmunologists have deep expertise in managing pediatric MS. They customize a treatment plan that reduces the frequency and severity of relapses, so your child has a less stressful, more enjoyable childhood.
• Team of experts: Lurie Children’s has all the experts your child needs to grow and thrive. Depending on your child’s needs, they may see specialists in neuropsychiatry, orthotics, ophthalmology, psychology, rehabilitation and other fields.
• Child-friendly infusion unit: Children who need IV treatments receive compassionate care at our pediatric infusion center. Our certified Child Life Specialists help kids feel comfortable as they receive treatments in a unit that has snacks, drinks, games, activities, movies and more.
• Developmental services: If MS affects your child’s behaviors, thinking or development, specialists at our Division of Developmental and Behavioral Pediatrics can help. We offer neuropsychological testing and other services to support your child as they grow and learn.
• Research and clinical trials: Our team’s active involvement in pediatric neurology research and clinical trials means your child may be able to try promising new MS therapies.

Lurie Children’s Neuroimmunology Clinic 

Lurie Children’s Neuroimmunology Clinic brings together an interdisciplinary team of experts to provide the latest, evidence-based treatments for children with MS. While MS is a lifelong disorder, proper disease management can help keep the disease in remission and ease relapses when they occur. Your child benefits from advanced care that lowers their risk of long-term complications and helps them lead the best life possible. 

Learn more about our Neuroimmunology Clinic.