Multiple Sclerosis

Treatment of Children

Until fairly recently, doctors didn't believe that children could get multiple sclerosis (MS). But growing evidence and more sophisticated diagnostic tools have proven that children as young as two years old can acquire MS and other demyelinating disorders. Approximately 8,000 to 10,000 children in the United States have been diagnosed with pediatric MS, and another 10,000 to 15,000 children have experienced a single episode of symptoms suggestive of MS, or which may lead to MS later in life. Specialists are developing treatment guidelines for these children, as well as research on why and how the disease develops in kids.

Children and adolescents who come to Mayo Clinic are treated by a multidisciplinary team with special expertise in treating pediatric MS. Children needing hospital care stay in the Mayo Eugenio Litta Children's Hospital in Minnesota, a family-friendly, state-of-the-art children's hospital within Saint Marys Hospital.

Mayo Clinic in Minnesota has longstanding expertise in caring for adult patients with MS and other related disorders, and also has an active MS research program. This expertise, combined with comprehensive pediatric specialty resources, allows Mayo to provide expert care for children and adolescents with MS and other demyelinating disorders of the central nervous system.

Mayo Clinic a "Pediatric MS Center of Excellence"

In 2006, Mayo was designated one of six Pediatric MS Centers of Excellence by the National Multiple Sclerosis Society. Mayo Clinic is the only location in the center of the country. This designation means that specialists at Mayo are:

• Establishing high-quality standards of care and treatment guidelines for children with MS;
• Collaborating with other Centers of Excellence in gathering data on each patient to learn more about how the disease affects children; and
• Educating both primary doctors and patients' families about pediatric MS.

Being a Center of Excellence also means that Mayo specialists have access to the latest information, research and treatments for MS in children.

Diagnosis

Because many doctors still think of MS as an adult disease, some pediatricians and family doctors can overlook MS symptoms simply because they're not expecting to see the disease in a child.

Diagnosing pediatric MS can be complex and involves several types of tests. Typically, doctors use the same evaluations and tests used to diagnose adults. See diagnosis. Improvements made to magnetic resonance imaging (MRI) in recent years have made it easier for doctors to see MS lesions on the brain and spinal cord. As a result, more kids are being diagnosed with MS and getting the help they need sooner.

One difference between adult and childhood MS is related to the type of MS: children almost always get the relapsing-remitting type; the progressive types are very rare in kids. In addition, the disease seems to progress more slowly in children than in adults.

Treatment Options

Doctors at Mayo Clinic currently are working to establish standards for treating children with MS. In the meantime, many children have successfully been treated using adult treatment options, including monitoring, medications to modify the disease, medications to treat symptoms, physical and occupational therapy, and counseling.

Adult MS medications haven't been studied for use in children, but doctors believe that they are generally safe for children to use in dosages appropriate to their size.

When a child has MS, it affects the whole family. The questions and fears can be overwhelming for a parent of a child with MS. The comprehensive care at Mayo is attentive to the needs of the family, offering coping tools and individual and family counseling.

Treatment Team

Because the effects of MS are scattered throughout the nervous system, each individual experiences MS differently — different symptoms, different impairments and different disease progression. At Mayo Clinic, a multidisciplinary medical team works together to address the unique needs of every patient. The team may consist of specialists from neurology, physical medicine and rehabilitation, orthopedics, psychology, social work and nursing.

The team's goals are to understand how MS is affecting the patient, treat immediate symptoms and prevent future functional impairment.

Appointments

To schedule an evaluation, refer a patient or request more information on treatment of pediatric MS, please call Heather Binner or Delana Weis, Pediatric MS Clinic Coordinators, at
1-866-598-4777 between 8 a.m. and 5 p.m. Central time, Monday to Friday.

Research

Although doctors know that acquired MS is caused by a combination of genetic and environmental factors, they don't yet know what the environmental triggers might be. Researchers think that exposure to triggers may happen in childhood; because children with MS are closer to the triggering event, doctors believe there's much to be learned about the disease in general by studying children.

Another area of active research is studying how the disease affects children. Neurologists have reported, for example, that some children with MS have cognitive difficulties that can affect their school performance. Studies have also shown that, after puberty, more girls are diagnosed with MS than boys, mirroring the same trend seen in adults with MS.

Research into childhood MS is an active area of research at Mayo Clinic. Many aspects of the disease need further study, and researchers are hopeful that the answers they discover for children will benefit all people with MS. Click here to read more about MS research at Mayo Clinic.