Multiple Sclerosis in Children

MS that starts in childhood is rare but is becoming increasingly diagnosed because of growing awareness that MS can begin at an earlier age than once thought. We’ve also developed improvements in testing that allow us to diagnose MS earlier on. This is critical because the earlier we can make the diagnosis, the quicker a child can start treatment that can prevent neurological problems. MS is challenging to diagnose, especially in children, because many other diseases (such as infections) can present in a similar way. That’s why pediatric MS care at Cleveland Clinic Children’s is a team effort. Multiple specialists work together to accurately diagnose and treat your child’s condition. Our expertise allows us to detect MS as early as possible, which often leads to better treatment response and improved quality of life.

This first thing we’ll do is give your child a neurological examination. It’s important to share your child’s neurological history and how their symptoms have been affecting their daily life with your child’s provider.  

Next, your child will likely have bloodwork and imaging tests, including:

• MRI to check for brain and spine abnormalities.
• Lumbar puncture (spinal tap) to check their spinal fluid for inflammation.
• Evoked potential (EP) testing to see how fast nerve signals travel across your child’s nervous system.
• Eye exam to check their vision.
• Psychological tests to measure how MS impacts their ability to think, learn and pay attention.

We use the information you give us and the results of these tests to craft a comprehensive and personalized treatment plan for your child. Some of these tests are repeated (usually every six months to one year) during follow-up visits to make sure the treatment is working the way it’s supposed to.

Since MS is a lifelong (chronic) illness, we work hard to develop a caring and compassionate relationship with each and every child and family member. We know the MS journey can be challenging, but following up with your treatment team throughout your child’s life (even when they’re doing well) makes sure that we’re always doing everything possible to help.

Meet Our Pediatric Multiple Sclerosis Team

Your child’s diagnosis and treatment team may include:

• Pediatric neurologists/neuroimmunologists.
• Neuroradiologists.
• Neuro-ophthalmologists.
• Neuropsychologists.
• Pediatric immunologists.
• Pediatric rheumatologists.
• Physical, occupational, speech and behavioral therapists (part of a rehabilitation team).
• Pain management specialists.
• Advanced practice providers (certified nurse practitioners, physician assistants).

There are many different ways we can treat MS in children. Since the disease affects each child differently, we work with you and your child to create a care plan that matches their unique needs.

Medications

We prescribe medications that slow down the condition’s progression and lower the risk of neurological problems later in life. These medications are known as disease-modifying therapies (DMT). They decrease relapses (attacks or flare-ups). Flare-ups usually show up as lesions (abnormal spots) that form in the brain or spine. We can see these lesions on your child’s MRI.

The more spots there are, the more problems they can cause (such as weakness, numbness/tingling, trouble walking and bowel/bladder problems, depending on where the spots are).

DMT therapies help prevent flare-ups and new spots and decrease the problems your child might have. It’s very important that your child takes their medication exactly as directed — forgetting to take it can lead to new problems that can affect their quality of life.

We might also suggest medications to treat other symptoms like pain, fatigue, anxiety or depression. Since MS can be overwhelming for anyone, especially a child, having them see rehabilitation specialists (for things like physical therapy to help with weakness), psychologists, psychiatrists and pain management specialists is a critical part of the treatment plan.

Taking the Next Step

Finding out your child has multiple sclerosis is challenging and can be overwhelming not only for them, but for your whole family, too. But Cleveland Clinic Children’s is here to give you hope and help your child live the fullest, most active life possible. Our expert, compassionate providers use advanced treatments that can slow disease progression. These treatments can protect your child’s long-term well-being and help your family plan for all aspects of your child’s life.