Multiple sclerosis living in children

Overview

Multiple sclerosis (MS) is a condition that affects the brain and spinal cord. The immune system, which normally fights infections, mistakenly attacks the protective covering of nerves. This can cause a range of symptoms that come and go, or that get worse over time. In children, MS is rare but manageable.

No, MS is uncommon in children. Fewer than 5% of all people with MS have symptoms before age 18.

MS can affect any child, but it is more common in girls than boys. The average age of first symptoms in children is about 12 years old, though it can start earlier.

Symptoms

Common symptoms

• Fatigue (extreme tiredness)
• Numbness or tingling in the face, arms, or legs
• Blurred or double vision
• Weakness in one or more limbs
• Dizziness or balance problems
• Bladder or bowel control issues

Symptoms in children

• Frequent relapses (flare-ups) that are often more aggressive than in adults
• Seizures (more common in younger children)
• Mood swings or irritability
• Trouble with walking or coordination
• Poor school performance due to fatigue or brain fog

Symptoms in older adults

• MS in older adults usually has more gradual progression and fewer relapses
• Greater risk of mobility and cognitive decline

Causes

Main causes

• The exact cause of MS is unknown. It is thought to be an autoimmune condition where the body's immune system attacks the myelin sheath (the protective coating around nerves).
• A combination of genetic and environmental factors likely triggers the disease.

Risk factors

• Family history of MS (having a parent or sibling with MS increases risk slightly)
• Living farther from the equator (less sun exposure and lower vitamin D levels)
• Infection with the Epstein-Barr virus (EBV)
• Being female (girls are more likely than boys to develop MS)
• Smoking exposure (secondhand smoke may increase risk in children)

When to see a doctor

See a doctor urgently if:

• If your child has any of the emergency symptoms listed above, call emergency services immediately.
• If your child has new or worsening neurological symptoms that do not go away, see a doctor urgently.

Book a routine appointment if:

• If your child has been diagnosed with MS, regular follow-up appointments are important to monitor for relapses and side effects of treatment.
• If your child experiences any new symptoms that come and go, mention them at the next check-up.

Diagnosis

Diagnosing MS in children can be challenging. A pediatric neurologist (a doctor who specializes in the brain and nervous system in children) will review symptoms, medical history, and perform tests to rule out other conditions.

Tests that may be done

• Magnetic resonance imaging (MRI) scan to look for areas of damage (lesions) in the brain and spinal cord
• Lumbar puncture (spinal tap) to check for certain proteins in the fluid around the brain and spinal cord
• Evoked potentials test to measure how quickly nerves respond to stimulation
• Blood tests to rule out other causes of symptoms

What to expect at your appointment

The diagnostic process may take weeks or months. Your child may need several appointments. Once diagnosed, the care team will help create a treatment plan tailored to your child's needs.

Treatment

There is no cure for MS, but treatments aim to reduce relapses, manage symptoms, and slow the progression of the disease. Treatment plans are individualized and may change over time.

Self-care at home

• Encourage your child to get enough rest and balance activity with breaks
• Stay cool: overheating can worsen symptoms (use air conditioning, cooling vests)
• Manage stress through relaxation techniques or hobbies
• Keep a symptom diary to track relapses and triggers
• Stay connected with friends and family to maintain a positive outlook

Medical treatments

Medical treatment includes disease-modifying therapies (DMTs) that are given as injections, infusions, or oral medications. These can reduce the number of MS attacks and slow disability progression. Steroid medications may be used for short periods during severe relapses. Symptom-specific treatments are available for issues like fatigue, bladder problems, or spasticity. All treatments should be discussed with a pediatric neurologist.

When is surgery considered?

Surgery is not a standard treatment for MS. In rare cases, procedures like deep brain stimulation or surgery for severe spasticity may be considered. Your doctor will explain if any surgical option is appropriate.

Living with this condition

Living with MS means learning to manage unpredictable symptoms. Help your child establish a routine that includes school, rest, and activities they enjoy. Communicate with teachers about your child's needs, such as extra time for tests or a quiet place to rest if fatigued.

Lifestyle tips

• Maintain a positive home environment where your child feels supported
• Encourage hobbies and social activities that are not overly tiring
• Plan ahead for good and bad days: have backup plans for schoolwork or outings
• Teach your child to listen to their body and rest when needed

Diet and exercise

A healthy, balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health. While no specific diet is proven to treat MS, adequate vitamin D and omega-3 fatty acids may be beneficial. Gentle exercise such as walking, swimming, or yoga can improve strength, balance, and mood without causing overheating. A physical therapist can design a safe exercise program.

Mental health and emotional wellbeing

MS can be emotionally challenging for children. They may feel frustrated, sad, or anxious about their symptoms or future. It is important to talk openly and offer reassurance. If you notice signs of depression (persistent sadness, withdrawal, loss of interest), seek help from a mental health professional. Remind your child that they are not alone and that many people with MS lead fulfilling lives.

Prevention

There is no known way to prevent MS. Research suggests that enough vitamin D, avoiding smoking, and maintaining a healthy lifestyle may reduce risk, but it is not proven.

Vaccines

Vaccines are safe for children with MS and are important for preventing infections. Your doctor can advise on timing and types of vaccines.

Screening programmes

There is no routine screening test for MS in the general population. Diagnosis occurs only after symptoms appear.

Complications

If left untreated

• More frequent and severe relapses that may not fully recover
• Accumulation of disability over time, such as difficulty walking or using hands
• Cognitive problems affecting memory, attention, or school performance
• Mood disorders like depression or anxiety

Long-term outlook

With early and effective treatment, many children with MS do very well. They can go to school, have friends, play sports, and grow up to lead independent lives. Research continues to improve treatments and outcomes. While MS is a serious condition, it does not define a child's future. With a strong support system and good medical care, children with MS can thrive.

Find support

International organisations

• Multiple Sclerosis International Federation (MSIF)
• National MS Society (US)
• MS Society UK

Local organisations

• Your child's neurologist or local hospital · Your region
• School counselor or special education services · Your region

Helplines

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