Is your little one suddenly having trouble walking? Or is their vision blurry or blurry? Sometimes these can be just minor things that come up. However, in rare cases, these symptoms can be the first signs of a disease that we don't talk about much, but it's very important to be aware of. Today we're going to talk about one such condition, called `Multiple Sclerosis` or `MS`, which affects children under the age of 18. Don't worry, we'll talk about this simply, in a way that you can understand.
What is the ``multiple sclerosis (MS)'' that these children develop?
Simply put, this is a disease caused by a malfunction in the immune system. Our body's immune system is like an army that protects a country. Its job is to protect our body by fighting germs and diseases that come from outside. However, in a child with `MS`, this immune system makes a small mistake. It starts attacking the healthy cells of its own body.
To be precise, this attack targets the child's Central Nervous System. That is, the brain and spinal cord. The nerves in the brain and spinal cord have a protective covering around them, like a plastic sheath around an electric wire. We call this covering ``Myelin.'' ``Myelin'' is what allows messages to travel quickly and smoothly through the nerves.
In MS, the immune system attacks and damages these myelin cells. It's like the electrical wire's sheath is cut in places. This causes nerve messages from the brain to the rest of the body to be blocked or disrupted.
This damage to myelin causes symptoms such as muscle weakness, fatigue, memory loss, difficulty walking, and changes in vision.
Imagine, your child has a friend named Nilanthi. Nilanthi suddenly starts to feel pain in one eye, and her vision is reduced. It is only when she shows it to a doctor that she learns that it could be an early sign of MS.
There is currently no cure for MS. However, there are effective treatments to control symptoms and reduce long-term disability caused by the disease. So there is no need to worry.
What types of MS occur in children?
The most common type of MS in children is ``Relapsing-Remitting MS (RRMS) .`` Approximately 98% of children have this type. In this case, symptoms come on suddenly (flare-up/relapse), last for a while, then decrease or disappear completely (remission). They may come back after a while. In this way, the symptoms come and go throughout the child's life.
The other type is ``Primary Progressive MS (PPMS)``. This is much less common in children. In this case, the symptoms gradually get worse over time. There are fewer intermittent remissions.
What are the early signs of MS in children?
When diagnosing MS, doctors pay special attention to these early signs:
- Optic Neuritis: This is a condition that causes pain in one or both eyes, along with loss of vision. Specifically, the optic nerve inside the eye becomes inflamed. Some children may also have a change in their color vision.
- Transverse Myelitis: This is when inflammation in a part of the spinal cord causes scarring, blocking nerve signals. This can cause symptoms such as weakness in the limbs, numbness, and inability to walk.
Imagine, your child, let's say his name is Kavindu. One day, when Kavindu comes home from school, he says, "Mom, my legs feel numb." After a while, he finds it difficult to walk. This could be due to Transverse Myelitis.
What are the common symptoms of MS in children?
The symptoms of MS can vary from person to person. Even in the same child, symptoms can vary from day to day. Not everyone will have all of these symptoms, but usually only a few will be seen.
- Numbness, tingling (paresthesia) : This sensation can occur in areas such as the hands, feet, and face.
- Dizziness
- Difficulty walking or keeping balance
- Fatigue: This is not just normal tiredness. It is a feeling of being tired no matter how much sleep you get.
- Muscle weakness
- Tremors/shaking
- Problems with concentration or memory
- Vision issues: such as blurry vision or double vision.
Just because you have one or two of these symptoms, don't assume it's MS. However, if these symptoms persist or your child is having difficulty, it's important to seek medical advice.
What causes children to develop MS?
The main cause of MS is demyelination . We talked earlier about the myelin sheath. Demyelination is the damage to the myelin sheath.
Our child's immune system, for some reason, mistakes this healthy part called `Myelin` as something harmful to the body. Then it starts attacking it. This attack damages the `Myelin`. Scars (also called `lesions` or `plaques` by doctors) can form in these damaged areas. These scars can be seen with scans such as `MRI (Magnetic Resonance Imaging)`.
When myelin is damaged, the transmission of messages from the brain to different parts of the body becomes disrupted. That's what causes the symptoms of MS.
Researchers still don't know exactly why the immune system misbehaves like this.
What are the risk factors for children developing MS?
It has been found that certain factors that affect the mother during pregnancy may increase the risk of her child developing MS:
- Exposure to toxins: For example, exposure to secondhand smoke, pesticides, etc.
- Low blood levels of vitamin D.
- Exposure to certain viral infections: For example, Epstein-Barr virus or mononucleosis (also known as the kissing disease).
- Obesity.
Therefore, it is very important to stay healthy during pregnancy. Following medical advice can reduce these risks.
What are the possible complications of childhood MS?
Children can develop certain complications due to MS. These often don't appear right away, and may only affect them as they reach adulthood.
- Difficulty walking without assistance.
- Depression and Anxiety.
- Difficulty doing schoolwork.
- Poor coordination of hands.
- Difficulty controlling urine or stool (incontinence).
Not all of these things affect every child, but it's important to be aware of these things so you can get help quickly if needed.
How do doctors diagnose MS in children?
A doctor diagnoses a child with MS by performing a physical exam, a neurological exam, and several other specialized tests . During these tests, the doctor will ask you questions about your child's symptoms and whether anyone in your family has had the disease.
Diagnostic tests also help rule out other conditions that have similar symptoms to MS. These tests include:
- Blood tests and urine tests.
- Imaging tests such as MRI (Magnetic Resonance Imaging) scans (there are also tests that look at the nerves of the eye, such as Optical Coherence Tomography).
- Lumbar Puncture: This involves taking a small amount of fluid around the spinal cord and examining it.
- Evoked Potential (EP) Test: This measures the speed at which messages travel through the nerves.
Because the symptoms of MS are similar to those of many other diseases, it can take some time to diagnose the exact condition. This can be a bit of a hassle for parents, and may require multiple visits to the doctor. However, once a correct diagnosis is made, it is possible to treat your child properly and help them have a happy, less-disruptive childhood.
Can young children recognize `MS`?
The symptoms of MS are not visible at birth. Therefore, it is very unlikely that a baby will be diagnosed with MS. The symptoms become apparent as the child grows older. The condition often begins during puberty. Most often, the disease is diagnosed before the age of 16.
How is MS treated in children?
The main treatment for relapsing-remitting MS (RRMS), which is common in children, is disease-modifying therapy (DMT). These DMT medications control the progression of the disease and reduce the frequency of symptoms. One drug approved by the FDA (Food and Drug Administration) is a pill called fingolimod . It is recommended for children 10 years of age and older. Other DMTs are currently being studied for use in children.
In addition, doctors also treat the child's specific symptoms. These may include:
- Occupational Therapy: Helps with daily tasks.
- Physical Therapy: Helps develop body strength and balance.
- Speech Therapy: If you have difficulty speaking or swallowing.
- Neuropsychological tests and treatments: Helps with things like memory, attention, and learning.
If the disease has affected the child's memory and thinking ability (cognitive function), additional support may be needed at school.
You may also have the opportunity to participate in clinical trials that test new treatments. Your doctor will tell you more about this.
When should I see my child's doctor?
If your child tells you about numbness, changes in vision, or any other unusual symptoms, it's important to talk to your child's doctor right away. Early detection of MS is best. Doctors can examine your child and determine the best course of action for a diagnosis.
After the disease is diagnosed, you or your child should notify the medical team if any new symptoms appear or if symptoms suddenly worsen (flare-up).
What is the future of children with childhood MS?
Children diagnosed with MS can generally have a positive outlook for the future. There are treatments to reduce the frequency and severity of symptoms. To prevent long-term disability, the disease must be managed throughout life. Your child will need to meet with their MS medical team regularly throughout their life.
Some children with relapsing-remitting MS (RRMS) can develop a condition called secondary progressive MS (SPMS) in adulthood. This is when symptoms gradually worsen. However, research has shown that people diagnosed with MS in childhood have a slower rate of disease progression than those who develop SPMS in adulthood.
Will MS affect my child's school life?
Because MS can affect a child's memory and thinking skills (cognitive function), the child may face challenges in schoolwork. Therefore, it is a good idea to have at least one neuropsychological test. After that, it is important to talk to the child's teachers regularly. You can get support to help the child move forward at their own pace and towards their educational goals.
Many children with MS get along well with other children their age. They can play and participate in activities just like other children.
If you have any questions, the doctor will advise you on whether certain activities are safe for the baby.
As a parent, you may be very worried when you learn that your child has MS. That's normal. But remember, most cases of MS that affect children are relapsing-remitting (RRMS). This means that symptoms come and go. A doctor can create a treatment plan to reduce the frequency and severity of symptoms. Although MS is a lifelong disease with no cure, if managed well, you can help your child play and learn with fewer interruptions.
Take-Home Message
- Childhood MS is a condition in which the immune system attacks the myelin in the nervous system.
- Symptoms vary, and may include vision problems, numbness, difficulty walking, and fatigue.
- The disease can be controlled with early detection and treatment like `DMT`.
- The child may need extra support at school and in everyday life, but most children can live a normal life.
- If your child has any unusual symptoms, seek medical advice immediately. Don't panic, with the right information and support, you can cope with this situation.
` Childhood MS, Multiple Sclerosis, Nervous System, Myelin, Immune System, Symptoms, Treatment
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