Has MS always been present in children and it hasn’t been diagnosed previously, or is it something that you’re seeing is more prevalent these days?
So I think that’s a really interesting question and it’s a question I’d love to do a proper study to answer. We’re definitely seeing many more young people referred into us and being diagnosed as having multiple sclerosis and I think there’s an increased awareness that people who have recurrent episodes of demyelination as a child can have MS. Previously it was thought that children didn’t get MS. But I feel that there do seem to be more young people with multiple sclerosis than previously and I don’t know though if this is just a referral bias. We previously looked at the number of patients who presented in the UK, nearly ten years ago now, with multiple sclerosis, and we were hoping to do another study in the next year or two to try and actually map it again to see if there’s been an increase in MS. We do know that a lot of other inflammatory diseases seem to be increasing, so it is possible that with the environment and different toxins that there may be more MS in young people.
And do you think it’s more prevalent or d’you think it’s because we’ve got better diagnostic tools now?
So, most of the time when I see a young person with multiple sclerosis, their presentation isn’t subtle. They present with sensory symptoms or weakness down one side, or sometimes cerebellar sometimes, and I think they would notice those symptoms ten, 15 years ago. We do have more access to MRI scans, but as you know, children relapse more frequently than adults do and I think that those children weren’t around and being picked up as much as they were, it was being, it was just being put to one side.
So are there particular – you say they relapse more than adults do – do they relapse in certain ways more than adults do, or is it across the board?
So, when a young person has multiple sclerosis the presentation is very similar to that which we see in adults. We get eye signs, optic neuritis, you get cerebellar signs, get some sensory signs, sometimes get some bladder involvement, very similar to what you’d see in adults. What we do see is that there’s more inflammation in young people and the relapse rate is two to three times higher than that which we see in adults. So the young people seem to have a more inflammatory condition than the adult situation.
And in terms of the mid to longer term prognosis for children if they’re diagnosed as children rather than adults, is that increased in terms of how fast it will progress?
So, there was a very, very good study, a lovely study that came out of Wales some years ago, which looked at young people who had been diagnosed under the age of 18. And what they recognise is although the young people had more relapses, it actually took them a longer time to accumulate the same level of disability that an adult had by a certain stage. So on average, the young people took 30 years to get to the same level of disability, the EDSS score, which is the Expanded Disability Status score, reached, they reached six after 30 years. Whereas the average adult would reach it after 20 years. But obviously the important thing is if you start your MS at 12, even 30 years later you’re still 42 and at a prime of your life where you’re actually needing to be physically very active. So that’s why we want to get in early with young people and intervene and try and prolong the duration before people accumulate disability.
[ends at 03:51]
How does MS present in children? Do children have different MS symptoms. Is it MS or is it something else. Find out with Nat and Katie Hanson, a Clinical Nurse Specialist.
MS Reporters are people living with Multiple Sclerosis. They’re interviewing world leading experts and making sense of the information they provide.
MS Reporter: Nat
Expert: Katie Hanson, Paediatric MS Nurse