Multiple Sclerosis affects everyone in different ways and different age groups in different ways. Oftentimes we may not think of Pediatric MS, but it affects almost 10,000 kids worldwide. Though that number is not as big as the number for adults, childhood diagnosis is hard not only for the child but the people around them to navigate and learn.
Pediatric MS is similar in many ways to Adult MS, but there are some significant differences. Firstly, the course of Ped-MS is relapsing remitting (except in rare cases), with frequent relapses, in other words frequent attacks of new or subsided symptoms. Moreover, during remissions, or the periods of peace between attacks, the disease does not progress. (“Who Gets MS? | National Multiple Sclerosis Society | National Multiple Sclerosis Society”)Research has shown, despite the ability for more damage in the form of lesions or cognitive dysfunction pediatric patients have commendable recovery often better than adults (Ghezzi et al.). In addition, lesions in Pediatric MS have a more pronounced inflammatory pattern.
Moreover, the diagnostic criteria is different for children less than 12 years of age with an ADEM like onset. ADEM or Acute Disseminated Encephalomyelitis is a disorder in which the patient experiences one brief attack of inflammation around the spinal cord and brain that damages the nerve-fiber coverings. (NIH) ADEM can be mistaken for MS, but it can develop into it. (“Differentiating ADEM from MS”) There still is preliminary research regarding differentiation of these two disorders and determining whether MS will develop, but advanced imaging technologies are making it easier for doctors.
New research is constantly in the works, especially regarding Pediatric MS. In a recent study, it was found that certain gut microbes are associated with multiple sclerosis activity. (Horton et al.)In this study, stool samples of Pediatric MS patients were used to analyze the gut microbiome and how it relates to clinical relapses and specific types of lesions. In another study, research concluded that a higher Vitamin D genetic risk score is correlated with lower vitamin D levels and more or a higher chance of relapses. (Graves et al.)
In terms of treatment, there are few options available for Pediatric MS. Though the FDA has approved several DMTs for adults with MS, that isn’t the case for children. The FDA approved the oral therapy Gilenya, a fingolimod, for children 10 in up. (Cleveland Clinic) Other treatments are being tested for child usage. Other ways of treatment can be lifestyle management and the individual treatment of symptoms through medications and therapy.
To summarize, Pediatric MS comes with its own differences that aren’t to be neglected and research has and will continue to be influential in the progression of this form of MS. Nonetheless, resources are constantly available either in the form of treatment or support groups.
Works Cited
Cleveland Clinic. “Pediatric Multiple Sclerosis: Causes, Symptoms & Treatments.” Cleveland Clinic, 13 April 2020, https://my.clevelandclinic.org/health/diseases/17337-pediatric-multiple-sclerosis. Accessed 19 August 2022.
“Differentiating ADEM from MS.” Johns Hopkins Medicine, 19 May 2010, https://www.hopkinsmedicine.org/news/articles/differentiating-adem-from-ms. Accessed 19 August 2022.
Ghezzi, Angelo, et al. “Pediatric versus adult MS: similar or different? - Multiple Sclerosis and Demyelinating Disorders.” Multiple Sclerosis and Demyelinating Disorders, 8 May 2017, https://msddjournal.biomedcentral.com/articles/10.1186/s40893-017-0022-6. Accessed 19 August 2022.
Graves, Jennifer S., et al. “Vitamin D genes influence MS relapses in children.” PubMed, 13 May 2019, https://pubmed.ncbi.nlm.nih.gov/31081484/. Accessed 19 August 2022.
Horton, Mary K., et al. “Gut microbiome is associated with multiple sclerosis activity in children.” Wiley Online Library, 19 August 2021, https://doi.org/10.1002/acn3.51441. Accessed 19 August 2022.
NIH. “Home.” National Institute of Neurological Disorders and Stroke, NIH, https://www.ninds.nih.gov/health-information/disorders/acute-disseminated-encephalomyelitis?search-term=disorders%20acute%20encephalomyelitis%20acute%20encephalomyelitis.htm. Accessed 19 August 2022.
“Who Gets MS? | National Multiple Sclerosis Society | National Multiple Sclerosis Society.” National MS Society, https://www.nationalmssociety.org/What-is-MS/Who-Gets-MS/Pediatric-MS. Accessed 19 August 2022.
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