Early Symptoms of Multiple Sclerosis in Children: What Parents Should Know

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system (CNS), causing a wide range of neurological symptoms. While MS is most commonly diagnosed in young adults, it can also affect children and adolescents, though it is rare in this age group.

A recent study published in JAMA Network Open on December 27, 2024, sheds new light on the various symptoms children may experience in the years leading up to an MS diagnosis.

This article explores these findings and provides a comprehensive understanding of how MS manifests in children before an official diagnosis.

Symptoms Before Diagnosis: What the Study Found

The study, led by Dr. Manas K. Akmatov and his team from the Central Research Institute of Ambulatory Health Care in Berlin, systematically examined the medical records of children diagnosed with MS.

The researchers focused on a period of five years before the first diagnosis of MS or any related central nervous system demyelinating disorder.

This is crucial because many pediatric MS patients experience symptoms long before they receive a formal diagnosis. In total, the study involved 1,091 children diagnosed with MS, 10,910 controls without MS, and 1,068 children with juvenile idiopathic arthritis (JIA).

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The study revealed a pattern of health conditions that were more commonly diagnosed in children with MS during the five years before their MS diagnosis. These symptoms were compared to two groups: one without MS and one with JIA, which shares some similarities in its symptoms.

Key Symptoms More Common in Children with MS

The researchers identified several key symptoms that appeared more frequently in children who would later be diagnosed with MS. These symptoms, measured by specific diagnostic codes, included:

• Obesity
• Disorders of eye refraction and accommodation
• Visual disturbances
• Gastritis and duodenitis
• Patella disorders
• Abnormal heartbeat
• Flatulence
• Skin sensation disturbances
• Dizziness and giddiness

These findings suggest that MS might be preceded by a variety of symptoms that could be misdiagnosed as other conditions or seen as unrelated.

How Common Are These Symptoms in Children with MS?

The study found that children who eventually developed MS had higher rates of these symptoms compared to children who did not develop the disease. Here is a comparison of some of the most common symptoms in children with MS versus those in the control group:

Symptom	Children with MS (adjusted odds ratio)	Children without MS (control)
Obesity	1.70	Lower prevalence
Visual disturbances	1.31	Lower prevalence
Skin sensation disturbances	12.93	Extremely low prevalence
Gastritis and duodenitis	1.35	Lower prevalence
Abnormal heartbeat	1.94	Lower prevalence

This table highlights the increased likelihood of specific symptoms in children with MS compared to those without it. For instance, children with MS were almost 13 times more likely to experience skin sensation disturbances compared to those without the disease.

Comparison with Juvenile Idiopathic Arthritis (JIA)

One important part of the study was comparing MS patients to children with juvenile idiopathic arthritis (JIA), a condition that can also involve inflammation and joint pain.

Although JIA and MS are distinct diseases, they can share certain neurological symptoms. The study showed that four symptoms stood out in children with MS when compared to those with JIA:

• Obesity
• Eye refraction and accommodation disorders
• Visual disturbances
• Skin sensation disturbances

Symptom	Children with MS (adjusted odds ratio)	Children with JIA (control)
Obesity	3.19	Lower prevalence
Visual disturbances	3.08	Lower prevalence
Skin sensation disturbances	27.70	Extremely low prevalence

As shown in the table, the odds of children with MS experiencing skin sensation disturbances were 27 times higher than those with JIA, and three times higher for obesity and visual disturbances.

Why These Symptoms Matter

Recognizing the signs and symptoms of MS before an official diagnosis is essential for early intervention. MS can be challenging to diagnose in children because its symptoms can overlap with other conditions like JIA or viral infections.

However, by identifying potential early warning signs, physicians may be able to provide earlier, more effective treatments, improving the long-term outcomes for children diagnosed with MS.

For example, visual disturbances and skin sensations that seem unremarkable could be early indicators of neurological issues that should be closely monitored.

Early diagnosis and treatment may reduce the severity of long-term neurological damage caused by MS and help children manage their symptoms more effectively.

Early Symptoms of MS: A Closer Look

Here are some of the most common early symptoms of MS in children, which may appear before an official MS diagnosis:

• Obesity: Children with MS may show higher rates of obesity before their diagnosis. This can be due to a variety of factors, including changes in metabolism caused by the disease’s early effects on the CNS.
• Visual Disturbances: Vision problems such as blurred vision, double vision, or loss of vision in one eye are common early symptoms of MS.
• Skin Sensation Disturbances: MS can cause abnormal sensations in the skin, such as tingling, numbness, or a “pins and needles” feeling. This symptom was one of the most strongly associated with MS in the study.
• Gastric Issues: Conditions like gastritis and duodenitis, which cause stomach discomfort and digestive issues, were found to be more common in children with MS.
• Dizziness and Giddiness: Balance problems, dizziness, and a feeling of unsteadiness can occur as the disease begins to affect the nervous system.

The Importance of Early Diagnosis

MS can be challenging to diagnose, especially in children, because many of its early symptoms mimic those of other conditions. However, recognizing these early signs and consulting with a healthcare professional can lead to quicker diagnosis and intervention, which can significantly improve the prognosis for affected children.

Conclusion

The findings of this study highlight the importance of recognizing early symptoms in children that could suggest the onset of multiple sclerosis. Symptoms like obesity, visual disturbances, and skin sensation changes are often seen years before a formal diagnosis is made. By understanding these early warning signs, parents, caregivers, and healthcare providers can work together to ensure a timely diagnosis and begin effective treatment early.

People May Ask

Q1: What are the earliest signs of MS in children?

Early signs of MS in children can include visual disturbances, skin sensation abnormalities, dizziness, and obesity. Some children may also experience fatigue, muscle weakness, or difficulty with coordination.

Q2: How is MS diagnosed in children?

MS is typically diagnosed through a combination of physical exams, MRI scans, and a detailed history of the child’s symptoms. Pediatric neurologists may also conduct additional tests to rule out other conditions with similar symptoms.

Q3: Can MS be prevented in children?

There is no known way to prevent MS, but early diagnosis and treatment can help manage symptoms and slow the progression of the disease. Children diagnosed with MS often require a combination of medications, physical therapy, and lifestyle changes.

Q4: How common is MS in children?

MS is relatively rare in children, but it can occur. It is estimated that about 2-5% of all MS cases are diagnosed in individuals under 18.

Q5: What treatments are available for children with MS?

Treatment for pediatric MS typically includes disease-modifying therapies (DMTs) to reduce the frequency of flare-ups and slow disease progression. Physical therapy, medications for pain management, and support for emotional and cognitive challenges are also essential aspects of treatment.

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