HealthCare Journey for Multiple Sclerosis
  • Home
  • About Us
  • Virtual MS Center
    • Q & A for Virtual MS Center
    • Read About Our Virtual MS Center Staff
  • News & Resources
  • Seminar Registration
  • Health & Wellness
  • Blogs
    • Physician Blog >
      • Healthcare Provider Blog
    • Physical Therapy Blog
    • Patient Blog
    • Caregiver Blog
    • Research Blogs >
      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
    • Treatment
    • MS Tips
  • Symptoms
    • Balance and Walking Issues
    • Breathing/Respiratory
    • Bowel Dysfunction
    • Cognitive Dysfunction
    • Crying/Laughing Uncontrollably (PBA)
    • Depression and Anxiety
    • Dizziness/Vertigo
    • Dysphagia
    • Fatigue
    • Foot Drop
    • Hearing or Smell or Taste Changes
    • Heat Sensitivity
    • Leg Weakness
    • Loss of Hand Dexterity and Coordination
    • Memory and Mutliple Sclerosis
    • Migraines
    • Numbness/Tingling/Altered Sensation
    • Nystagmus and Oscillopsia
    • Pain
    • Sexual Dysfunction
    • Sleep Issues
    • Spasticity/Spasms/Cramps
    • Speech/Swallowing
    • Urination/Bowel Problems
    • Vision
  • MS Clinics
  • MS Topics
    • Pregnancy and Infertility
    • Caregivers and Family Members
    • Employment and MS
    • Medical Costs and Insurance
    • Pediatric Multiple Sclerosis
  • Register With Us
  • Terms of Use/Privacy/HIPAA
  • MS HealthCare Journey

Welcome to the Virtual MS Center!

Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
CLICK HERE TO ASK YOUR QUESTION!

How different is it to diagnose pediatric versus adult onset Multiple Sclerosis (MS)?

4/4/2014

 
Picture
Approximately 5% of people with MS experience onset of the disease under the age of 16. The diagnostic criteria for adult and pediatric onset MS is identical but the differential diagnosis differs; specifically, children more commonly experience acute disseminated encephalomyelitis (ADEM), a mono phasic form (this means it happens once unlike MS) of inflammatory demyelination most commonly associated with recent viral infections or immunizations.  The international pediatric MS consortium has established diagnostic criteria for MS and ADEM to ensure that children with ADEM do not prematurely receive a diagnosis of MS. ADEM can look very similar to MS at first but the children rapidly become quite ill and encephalopathic (meaning confused and lethargic often with behavior changes and sometimes progressing to coma), which is very rare in MS, and the MRI appearance is typically quite different. Unfortunately, 10-20% of children do not recover well from ADEM and some will even go on to develop MS. Other conditions considered quite rare in adults must also be considered in a child presenting with an MS-like disorder, but these conditions are usually easy to exclude by an experienced neurologist with appropriate diagnostic evaluations.

There are key features of Pediatric MS that dictate a slightly different therapeutic approach compared to adult onset MS:

1. Kids with MS tend to experience far more inflammatory activity than adults; This means more relapses and more new lesions developing on repeat MRI scans.  This also makes it far easier to use relapses and MRI activity to guide therapeutic decisions. In my experience it is important to initiate therapy early in these children, monitor their response closely and alter therapy if they are not responding either by clinical or radiological criteria.

2. While there is no evidence that kids respond differently to disease modifying therapy, they certainly hate injections as much as adults and in my experience require a lot of guidance and supervision to make sure they keep to their treatment schedule. This is particularly true of kids with MS once they leave home to go to college. Newer oral and infused therapies may improve adherence to treatment regimens

3. Kids with MS are often treated with IV immunoglobulin (Ig) for relapses, a practice now rare in adults. I rarely find that IV Ig therapy is as useful as treatment with steroids in kids or adults. If a kid does not respond to high dose steroids for a relapse, I prefer to treat them with plasma exchange

4. Kids with MS often look quite good to the casual observer but cognitive problems occur early and can interfere with learning and school; if unrecognized these cognitive problems may manifest as a behavioral disturbance. Kids with MS do best with learning center evaluations and adaptions that allow them to thrive better in school. This is particularly true when frequent relapses interfere with large chunks of the school year.

5. Kids with MS tend to develop disabilities at a younger age, but it is hoped that early aggressive treatment will change this outcome.

6. Kids with MS do best with support and interaction with other kids with MS; remember they are really a minority and most programs are geared for adults.

7. Lastly, it is important to look after the parents of kids with MS. They are the best resource available to the child but the disease can cause a lot of stress and family disruptions.  Supportive group activities for parents, especially those with disabled children, and the ability to get away even for a few hours are highly constructive. It is also best for parents to have direct assess to their doctor for emergencies or concerns. The Pediatric Multiple Sclerosis Alliance is just organizing and would be a great place to start for support. You can click on this link for pediatric MS groups and resources:
http://www.healthcarejourney.com/pediatric-multiple-sclerosis.html


-Rip Kinkel, MD


Comments are closed.

    RSS Feed

    PLEASE NOTE: This information/opinions on this site should be used as an information source only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
    Read About Our Virtual MS Center Authors

    Archives

    March 2023
    February 2023
    January 2023
    December 2022
    October 2022
    September 2022
    August 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    July 2013
    June 2013

    Categories

    All
    Accessible Housing And Environmental Modifications
    Anxiety
    Balance
    Bowel Problems
    Caregivers
    Cognitive Function
    Compliance
    David Rintell Ed. D.
    Deborah Backus Blogs
    Depression
    Diagnosis
    Diet
    Dizziness
    Dosing
    Dr. Greenberg's Q&A
    Dr. Kinkel's Q&A
    Dr. Miravalle's Q&A
    Dr. Nielsen's Q&A
    Dr. Osborne's Q&A
    Exercise
    Experimental Treatments
    Eye Surgery
    Fatigue
    Fatique
    Flu Shot
    Foot Drop
    Herbs
    Immunosuppression
    JCV
    Lasik Surgery
    Lesions
    Lori Kostich's Q&A
    Lyme Disease
    Medications
    Migraines
    Mobility
    MRI
    MS Hug
    Other Diseases
    Pain
    PML
    PPMS
    Pregnancy
    Relapse
    Safety
    Sarah Wargo's Q&A
    Sexual Dysfunction
    Side Effects
    Smoking
    Spasticity
    Stem Cell Transplantation
    Steroids
    Stress
    Supplements
    Surgery
    Symptoms
    Treatment
    Urination
    Viruses
    Vision
    Vitamin D
    Vitamins
    Weakness


© 2022 HealthCare Journey, LLC. All Rights Reserved.
HealthCare Journey™ is a trademark of HealthCare Journey, LLC
Picture
  • Home
  • About Us
  • Virtual MS Center
    • Q & A for Virtual MS Center
    • Read About Our Virtual MS Center Staff
  • News & Resources
  • Seminar Registration
  • Health & Wellness
  • Blogs
    • Physician Blog >
      • Healthcare Provider Blog
    • Physical Therapy Blog
    • Patient Blog
    • Caregiver Blog
    • Research Blogs >
      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
    • Treatment
    • MS Tips
  • Symptoms
    • Balance and Walking Issues
    • Breathing/Respiratory
    • Bowel Dysfunction
    • Cognitive Dysfunction
    • Crying/Laughing Uncontrollably (PBA)
    • Depression and Anxiety
    • Dizziness/Vertigo
    • Dysphagia
    • Fatigue
    • Foot Drop
    • Hearing or Smell or Taste Changes
    • Heat Sensitivity
    • Leg Weakness
    • Loss of Hand Dexterity and Coordination
    • Memory and Mutliple Sclerosis
    • Migraines
    • Numbness/Tingling/Altered Sensation
    • Nystagmus and Oscillopsia
    • Pain
    • Sexual Dysfunction
    • Sleep Issues
    • Spasticity/Spasms/Cramps
    • Speech/Swallowing
    • Urination/Bowel Problems
    • Vision
  • MS Clinics
  • MS Topics
    • Pregnancy and Infertility
    • Caregivers and Family Members
    • Employment and MS
    • Medical Costs and Insurance
    • Pediatric Multiple Sclerosis
  • Register With Us
  • Terms of Use/Privacy/HIPAA
  • MS HealthCare Journey