Pediatric MS

About Multiple Sclerosis: Multiple Sclerosis (MS) is thought to be an autoimmune disease that affects the brain and spinal cord. White blood cells, which are part of the body’s immune system normally fight infection. In MS, these white blood cells become mis-programmed and attack the brain and spinal cord. The axons are part of a neuron (nerve cell) and are used to transmit information to other nerve cells. The main target of this immune attack in MS is the myelin covering over an axon. Therefore MS is often referred to as a demyelinating disease. The myelin coating of an axon is analogous to rubber insulation over an electrical wire, and efficient electrical transmission requires intact myelin. Damage to the nerves and their myelin coating causes the neurological symptoms that affect people with MS. Neurological signs typical for MS include symptoms of weakness, numbness, tingling, dizziness, and blurred or double vision. The majority of patients with MS experience relapses or attacks, caused by waves of white blood cells attacking the brain or spinal cord. Some patients experience irreversible or progressive symptoms.

Pediatric MS: MS usually starts in patients 20 to 30 years of age, however it has become increasingly recognized that MS occurs in children and teenagers. Current estimates suggest that about 5% of all MS cases start in childhood or adolescence. Children with MS experience many of the same symptoms that adults do, however because of age differences may not recognize these symptoms as readily. We have also found that children can experience more frequent relapses than adults. There is evidence that treatment with immunomodulatory agents for MS is safe and effective in children. Care of a child or adolescent with MS requires a multidisciplinary team, which includes evaluation by a neurologist, as well as neuropsychologist and other caregivers.

MRI-features of Pediatric MS: The ability to obtain high quality images of the brain using magnetic resonance imaging (MRI) has dramatically improved the ability to diagnose multiple sclerosis (MS) in both children and adults.

MRI studies have shown that children with MS have as many, if not more, MS lesions compared with adults. MS also has an impact on normal brain growth during childhood and disrupts normal brain pathways – which explains why some children and teens with MS have difficulty with learning and other cognitive tasks.

The ability of MRI to guide treatment is an active area of research, and MRI studies are a key component of clinical trials of new MS therapies. Read a recent IPMSSG paper on MRI in pediatric MS.