MS in children

The medical names sometimes used for childhood MS are paediatric MS or paediatric onset MS (POMS).

MS is rare in children, and it’s difficult to diagnose because there are other conditions that have similar symptoms. But treatments are available that can help manage children’s MS symptoms, and even change the course of their MS.

What age can you get MS? 

People can be diagnosed with MS at any age. Most people diagnosed with MS are in their 30s or 40s. But people are diagnosed older or younger than this. Childhood MS is rare, but some people are diagnosed as teenagers or children. 

Some adults with MS recall early symptoms from when they were children, even if they weren’t diagnosed until they were adults. As many as 1 in every 10 people with MS might experience their first symptoms before the age of 16.

How is MS diagnosed in children? 

MS is diagnosed in children and adults by putting together evidence from lots of different places, including asking about symptoms and doing tests. The tests for diagnosis often include an MRI scan to take images of the brain and a lumbar puncture to test the fluid around the spinal cord. 

There's no single test for MS. And MS isn't a common diagnosis for children. So doctors need to consider lots of other possible causes. Even a specialist doctor might sometimes need to monitor things for a time, to have enough evidence for a correct diagnosis.

It might take many weeks or months to get a confirmed diagnosis. Doctors should explain to you what the next steps are during the process. And children can get support and care for symptoms they might have, even before they're diagnosed. 

Specialist neurologists

Your child should be examined by a paediatric neurologist. This is a doctor who specialises in conditions affecting a child’s central nervous system. These experts might not be at your closest hospital. 

For example, in England there are 6 hospitals which are part of a Highly Specialised Service. They treat children who have – or might have – MS or a similar condition. So you might be referred to one of those for diagnosis, treatment and care.

We’re here to support you

If your child is diagnosed with MS, or is having tests to find out what’s wrong, this can bring up strong feelings for everyone involved. It’s natural to feel afraid, confused, upset or overwhelmed. You may also feel relieved – that finally you know what’s wrong and that you’re not imagining it. That now you can take more steps to look after your child and think about treatment.

However you feel, we’re here to support you.

What causes MS in children?

In MS, your immune system attacks nerves in your brain and spinal cord by mistake. This damages your nerves, and means they don’t work properly.

Certain things seem to play a part in triggering MS in children. Just as with adults, it’s probably a combination of several things, including your genes and some lifestyle factors. These could include having previously had the Epstein Barr virus, having low levels of vitamin D and being overweight.

But childhood MS is no one’s fault. No-one can ever be sure exactly what things have come together to cause MS in each person. So it’s unlikely you or your child could have done anything to avoid it. 

Read more about what causes MS

How will MS affect my child?

MS affects people of all ages in different ways, so it’s hard to say how each person will be affected. But research suggests that some things about MS are common for childhood MS. 

Childhood MS symptoms

There are many different symptoms of MS. One of the most common symptoms in children is problems with memory and thinking. Other common childhood MS symptoms include problems with movement, like poor coordination and tremor, problems with vision, and sensory symptoms – like tingling or numbness. But MS is different for every child, just as it's different for every adult.

Children and teenagers might also experience MS fatigue. That can be an overwhelming physical tiredness. It can also make it hard to think clearly or concentrate while the fatigue is happening. We’ve got short online modules to help manage fatigue. And the NHS has guidance on ways teenagers and children can pace themselves if they get fatigue.

Discover our online fatigue management course

Find out more about managing MS symptoms

Types of childhood MS

Nearly all children with MS have a type called relapsing remitting MS. This means that they have times where their symptoms suddenly get worse (relapses), followed by periods of recovery. 

Treatments called disease modifying therapies (DMTs) can help children. DMTs can reduce how many relapses your child has, and slow down how quickly their MS progresses.

There are two other main types of MS, but it’s rare for children to get these. 

• Primary progressive MS. This means your MS gets worse over time, without periods of recovery.10 Around 2 in 100 children with MS have this type.
• Secondary progressive MS. This develops in people who have previously had relapsing remitting MS. You have fewer relapses and instead your symptoms get steadily worse. Children with relapsing remitting MS are unlikely to develop secondary progressive MS while they’re still a child.

CIS and RIS

Sometimes people are diagnosed with CIS or RIS. Children and adults can be diagnosed with these. They stand for Clinically Isolated Syndrome (CIS) and Radiologically Isolated Syndrome (RIS). CIS and RIS can be the diagnosis if there are only signs of one MS-like attack in the nervous system. 

Some people with CIS or RIS later develop MS, but not everyone. Some people are offered MS treatments if they’re diagnosed with CIS. 

Read more about CIS

Read more about RIS

How is MS different in children?

There are a few ways childhood MS is different to MS in adults. But these differences are all based on averages – so a child’s own experience might be different to this. 

• Children might have more symptoms and more severe symptoms than adults when they’re first diagnosed
• Children might also get more frequent relapses early on. They tend to have a better recovery from these relapses than adults
• MS in children progresses more slowly than in adults. Children tend to take 10 years longer to develop secondary progressive MS
• Although it progresses more slowly, children may become disabled at an earlier age overall. That’s because their MS begins at a younger age

How can my child’s MS be treated?

Childhood MS can be treated and managed in lots of different ways. It should always be a holistic, personal thing – taking into account your child’s symptoms, their type of MS, and their circumstances. For example, it could be a combination of drug treatments, physiotherapy, exercise and healthy eating, with support from different health and social care professionals. 

Lots of treatments for MS aren’t licensed specifically for children. But that doesn't mean they won’t be useful or can’t be used, with careful monitoring by doctors. 

Disease modifying therapies (DMTs) for childhood MS

Lots of children with MS are offered a disease modifying therapy (DMT). If it’s available, a DMT can make the biggest long-term difference to your child’s MS. DMTs could: 

• reduce how many relapses your child may get
• slow down how fast your child’s disability or symptoms get worse

Your child’s neurologist may be able to prescribe a DMT. They can discuss the DMT options for your child, which could include drugs that are:

• given as an injection or infusion at hospital, like ocrelizumab (Ocrevus) or natalizumab (Tysabri or Tyruko)
• taken as an injection at home, like ofatumumab (Kespimpta), beta interferons (Avonex, Rebif or Plegridy) or glatiramer acetate (Copaxone or Brabio)
• taken as tablets at home, like fingolimod (Gilenya), dimethyl fumarate (Tecfidera) or teriflunomide (Aubagio)

Before starting a DMT you might need to show that your child is up to date with their vaccinations. If you don’t have a record of the jabs they’ve had, they might need to catch up with those before they start the treatment.

Find out more about DMTs for MS

Managing relapses

If your child has an MS relapse, their doctor might offer a course of steroids. Steroids can speed up recovery from a relapse and reduce how severe the symptoms are. Taking steroids or not doesn’t affect how MS progresses over the long term.

Rehabilitation after a relapse can help them recover. This could include physiotherapy, occupational therapy, and support at home or school.

If your child has a mild relapse, they may not need any special treatment. They’ll just keep on taking their DMT if they’re on one.

Read more about managing relapses

Living with childhood MS

Many of the ways MS symptoms are managed are similar for children and adults. But living with MS as a child can present its own challenges. For example, coping with school or college.

Read more about living with childhood MS

Read more about education and MS