Multiple Sclerosis in Children and Adolescents
Multiple Sclerosis in Children and Adolescents
Multiple sclerosis is a potentially devastating chronic neurologic disease that appears in both children and adults. Symptoms are often severe and include muscle weakness, partial paralysis, vision problems and balance issues. However, preventive treatment at a young age at Sheba Medical Center can delay progression of the disease.
Multiple sclerosis (MS) is a neurological disease caused by damage to the central nervous system. MS classifies as an autoimmune disease, meaning the immune system misidentifies various systems/tissues as external invaders and attacks these tissues via lymphocytes and other immune responses.
Dr. Shay Menascu, a neurologist and senior physician at the National Multiple Sclerosis Center at Sheba Medical Center, explains, “In MS, the autoimmune response is directed against myelin proteins (the protective sheath that covers nerve fibers), which are identified as foreign bodies and thus cause an inflammatory response and communication problems between the brain and the rest of the body.
Eventually, the disease can cause the nerves themselves to deteriorate or to become permanently damaged. Multiple sclerosis can affect any region of the central nervous system”.
Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which specific nerves are affected. Some people with severe MS may lose the ability to walk independently or to walk at all, while others may experience long periods of remission without any new symptoms.
There is no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and assist in managing symptoms.
Symptoms of Multiple Sclerosis
The signs and symptoms of multiple sclerosis may differ from person to person and during each stage of the disease. The symptoms are largely dependent on the location of the affected nerve fibers. Symptoms may include:
- Numbness or weakness in one or more limbs. These symptoms typically occur on one side of the body at a time or are limited to only the legs and trunk.
- Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
- Prolonged double vision
- Tingling or pain various body parts
- Electric-shock sensations that occur with certain neck movements, especially while bending the neck forward
- Tremor, lack of coordination or an unsteady gait
- Slurred speech
- Problems with bowel and bladder function and control
Multiple Sclerosis Disproportionately Affects Young People and Women
The number of people suffering from MS worldwide is estimated at one million, with about 450,000 of those in the United States. Approximately 10,000 new patients are diagnosed with MS every year. Risk factors for developing MS include:
White people, particularly those of Northern European descent, are at the highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
The chances of developing MS increase if there is another family member who has the disease. In fact, 15% of MS patients have a relative also suffering from the disease.
MS can occur at any age, but most commonly affects people between the ages of 15 and 60. The peak is around 25 years of age.
Women are about twice as likely to develop MS as men.
In addition to genetic factors, there are also environmental components to MS:
- Certain infections. Studies have shown a link between multiple sclerosis outbreaks and infections caused by various viruses. There is evidence that viral infections may be a catalyst for the development of autoimmune diseases like MS. These viruses include Epstein-Barr, the virus responsible for infectious mononucleosis.
- Smoking. Smokers who experience symptoms that may indicate MS are more likely than nonsmokers to go on to develop a second event, and therefore, smokers are more likely to be diagnosed with relapsing-remitting MS. Relapsing-remitting MS is a type of the disease characterized by flares, or relapses of symptoms.
Dr. Shay Menascu summarizes, “There is growing awareness around the world that MS may begin in childhood or adolescence, and estimates state that between 2% and 5% of MS cases were diagnosed before the age of 16.
Children are not young adults, so the diagnosis of multiple sclerosis in children is performed according to various criteria. Therefore, a correct diagnosis requires that other types of diseases and disorders with symptoms similar to those of multiple sclerosis be ruled out.”
Early Preventative Multiple Sclerosis Treatment
In most cases of children with MS, the disease manifests slowly. There are reportedly more seizures in children than adults with MS, but most of the signs are temporary and pass faster than in adults. From a functionality point of view, it takes an average of 20 years for a child with MS to manifest severe, debilitating symptoms. Comparatively, this period is about ten years for adults with an MS diagnosis.
Children with MS typically have a better course during the early stages of the disease. However, the prognosis for pediatric patients may worsen over time as the child develops motor and cognitive problems. In some cases, MS progresses quite rapidly in children and may be accompanied by extreme symptoms, such as repetitive seizures.
This phenomenon reinforces the urgent need to begin treatment for MS as soon as possible after a diagnosis. Such treatment often includes the use of the same medications applied in adult cases of MS.
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