Multiple Sclerosis No Longer Just an Adult Disease
Multiple sclerosis (MS) – once considered an “adults-only” disease – is increasingly being diagnosed in children and adolescents, a fact that puts pediatricians on the front lines when it comes to recognizing its symptoms.
“Up until recently, we had never thought of MS as a childhood disease,” says pediatric neurologist Geetanjali Rathore, MD, with Children’s Hospital & Medical Center in Omaha. According to Dr. Rathore, an estimated 10 percent of all MS cases now present before age 18.
The National Multiple Sclerosis Society says as many as 8 to 10 thousand American children age 18 and under have MS, and another 10 to 15 thousand have experienced at least one symptom suggestive of MS. The disease involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system.
“If a person is diagnosed with MS at age 40, they will accumulate disabilities as the disease
progresses,” Dr. Rathore says. “But a person who is diagnosed at age 15 will accumulate significantly more disabilities as the disease progresses through the course of their life. This emphasizes the need for early diagnosis and treatment.”
Dr. Rathore says that diagnosing MS in children is more challenging than in adults because many other childhood disorders, such as acute demyelinating encephalomyelitis, exhibit similar symptoms and characteristics.
“Most pediatricians do not expect to find MS in children so they may not be looking for it,” Dr. Rathore says. “But if a child presents symptoms that indicate the possibility of MS, the pediatrician should refer to a specialist who is experienced in diagnosing and treating MS.”
Dr. Rathore says a diagnosis requires evidence of damage in at least two separate areas of the central nervous system – which includes the brain, spinal cord and optic nerves – and evidence that the damage occurred at least one month apart while also eliminating all other possible diagnoses.
“It is a combination of clinical evaluation, a recent episode and MRI evidence of a prior event,” Dr. Rathore says. “With this information, we can diagnose MS at the patient’s first clinical presentation. With many neurological disorders, early treatment leads to better outcomes.”
Dr. Rathore and her colleaat the Neurology Clinic at Children’s regularly diagnose and treat disorders of the nervous system and diseases of the brain, spinal cord, nerves and muscles. In addition to her work in pediatric MS, Dr. Rathore has a special interest in other pediatric autoimmune disorders.