What is multiple sclerosis (MS) ?
MS is a condition that occurs in the central nervous system. The coating around nerve fibers known as myelin is damaged by the body’s immune system, which mistakes myelin for a foreign body and attacks it. Nerve fibers help the brain and the rest of the body to communicate. When they are stripped of myelin, lesions or plaques would form that disrupt the messages travelling along nerve fibers partially or completely. The messages are distorted and cannot get through at all. The actual nerve fibers may also become damaged.
The type of symptoms that appear vary, depending on which part of the central nervous system is affected and what function the damaged nerve had. MS is usually diagnosed between the ages of 20 to 40, and affects approximately three times as many women as men. There is no cure for this condition but there are treatments that can help manage the symptoms.
MS in children
MS is usually an adult disease, but the number of children and adolescents that are being diagnosed with MS is on the rise. Research suggests that two to five percent of all people with MS experience MS symptoms before the age of 18.
Neurologists think that many children have MS but are not diagnosed. Medical practitioners find diagnosing MS in children much more challenging than in adults because many childhood disorders have similar characteristics and symptoms. Pediatricians may not be familiar with MS and do not expect to see it in children.
Symptoms of MS in children
- Difficulty walking
- Physical weakness and lethargy
- Poor body co-ordination
- Tremors
- Problems with bladder control
- Muscle spasms
- Sensory changes, tingling, or numbness
- Changes in vision
- Tremors
- Seizures (not typical in adults with MS)
MS symptoms come and go and can be mild or severe. MS symptoms vary from person to person. The time the symptoms last also vary. Some symptoms may linger after an attack such as muscle stiffness, tiredness, numbness or tingling, and depression. Infections or fevers may temporarily worsen MS symptoms, but will lessen once the infection or fever subsides. Adults with MS do not typically have symptoms such as lethargy or seizures.
Multiple sclerosis may appear differently in children than it does in adults. There may be temporary neurological symptoms in children such as coma, delirium, fever, headache, lethargy, seizures, and stiff neck. Children with MS will continue to have these symptoms and additional signs.
The severity and location of attacks vary. Episodes can last for days, weeks, or months, and alternate with periods of less or no symptoms. Attacks may be triggered or worsened by hot baths, fever, and stress. Patients may experience a period of remission, and then relapse. The disease sometimes becomes worse without a period of remission. Children often experience relapses more often than adults with early MS.
Scientists think that MS progresses more slowly in children than adults. People who being to have MS in childhood or adolescence can experience significant disabilities at an earlier age than adults with MS. Young people may also experience psychological and cognitive damage that will affect their self-image, academic performance, and relationships with others.
MS often affects the brain’s cognitive abilities, such as remembering to do things and remembering recent events. Many people with MS report they need more time and effort to recall a memory. People with MS find it difficult to concentrate for long periods of time. They also lose track of what they are doing if they are interrupted.
It is difficult for them to carry on a conversation or do several jobs at once when they are distracted by radio or TV. Making decisions and solving problems are also difficult. Children and youth will struggle in school to concentrate and complete tasks.
MS Diagnosis
Neurological exam: There are a number of tools that will be used to diagnose MS. A neurologist will ask a lot of questions about past symptoms and problems to identify the cause of the current symptoms. The neurologist will check for changes or weaknesses in leg or hand coordination, eye movements, balance, speech, sensation, or reflexes. A neurologist may suspect MS, but will not make a diagnosis until other test results confirm MS.
Magnetic Resonance Imaging (MRI): An MRI scanner is a painless procedure that uses a strong magnetic field to create a detailed image of the spinal cord and brain. MRIs can pinpoint the exact location and size of any lesions or damage.
Lumbar puncture: A lumbar puncture, also known as a spinal tap, involves inserting a needle into the space around the spinal cord while under a local anaesthetic. A small sample is taken of cerebrospinal fluid, the fluid that flows around the brain and spinal cord, and is tested for abnormalities. People with MS often have antibodies in the fluid.
Other tests: Other tests may be done such as blood tests to check for specific antibodies, and inner ear tests to check the patient’s balance.
Effect on the Family
Children with MS may react to their diagnosis with mood swings, depression, and anxiety. They can become aggressive. MS symptoms are unpredictable and can have a negative impact on communication and relationships.
The parents may focus a lot of attention to the child with MS, so the other siblings may feel jealous or resentful and express their feelings in bad behavior. It is important for families to have an open discussion about MS and share information about the nature of the condition.
Treatment
Some medications for MS are not approved for treatment of patients under the age of 18, however, there are some medications available that can reduce inflammation in the brain and spinal cord. In the U.S., the U.S. Food and Drug Administration have approved some self-injectable disease-modifying therapies in trials meant for adults that are also well tolerated and safe in children.
Medical professionals must monitor the patients closely. Physical and occupational therapy, and counseling can also help relieve symptoms.
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