Multiple sclerosis (MS) is a condition where the immune system attacks the central nervous system (brain and spinal cord). Although MS can appear at any age, it’s more common in adults. Most people are 20 to 50 years old when they’re diagnosed. However, children and adolescents can also experience this autoimmune disease — up to 1 in 20 people with MS develop symptoms before age 18, and fewer than 1 in 100 show symptoms before age 10. MS is also more common in females than males.

MS Symptoms in Children and Adolescents

MS symptoms can be hard to spot because they often change. For example, your child might have one symptom this week and a different one next week as new lesions (areas of damage) develop in different parts of the body. Symptoms can also get better or worse over time.

Pediatric MS symptoms are usually similar to adult-onset MS symptoms. However, nearly all children with the condition have relapsing-remitting MS (RRMS), a type of MS in which symptoms first relapse or flare up (get worse) and then go into remission (get better). Children also experience relapses more often than adults.

Although many other factors can cause symptoms similar to those of MS, one clue that your child might have MS is if their symptoms go away for a while and then come back.

Below are some common MS symptoms in children and teens. Your child may have one or several of these, or they may experience other symptoms not listed here. Keep in mind that these pediatric multiple sclerosis symptoms cannot be used to diagnose the disease. These symptoms can also be caused by other conditions. A healthcare provider can only make an MS diagnosis after tests like an MRI (magnetic resonance imaging) scan and other tests show evidence of multiple lesions (or plaques) in the central nervous system.

1. Balance Problems

Although people of all ages with MS may experience balance difficulties, this symptom is more common in children than in adults. This symptom might cause your child to:

• Move more slowly
• Walk unsteadily
• Hold onto nearby items to help themselves move around
• Feel dizzy

Many members of MyMSTeam have said they now realize they had MS symptoms when they were children but didn’t realize it at the time. “I had vertigo as a young kid,” said one member. “I would fall for no reason,” commented another.

Balance problems aren’t always a sign of MS. Ear infections — which are very common in children — can also cause this symptom. Other possible causes include:

• Headaches
• Head or neck injuries
• Genetic disorders
• Certain medications

2. Muscle Problems

Pediatric multiple sclerosis symptoms include muscle weakness, tremors, and spasticity (tightness or stiffness). In some cases, the muscles may suddenly stop moving normally. MS can also affect coordination. This common symptom also affects children with MS more frequently than adults.

If your child has muscle symptoms, you may notice they often drop things or have trouble writing or drawing. Your child may struggle to move normally or do the activities they used to enjoy.

One member whose symptoms began in childhood shared, “I remember my dad saying from time to time that I was clumsy.” Another member remarked, “My sister remembers that we went to a movie and afterward, I couldn’t stand to walk. My dad had to come and carry me out.”

One member also mentioned that movement problems were the first sign of MS in their child. “My son insisted that the problem with his hand was not normal and that he could not play the piano properly anymore,” they said.

3. Tiredness or Fatigue

Many people with MS experience fatigue. Your child may start sleeping more than usual, fall asleep at school, or say they’re too tired to participate in sports or hobbies.

A member who had symptoms as a child remembered, “In elementary school, I had a semester when I was exhausted all the time.”

Your child may also feel tired due to sleep problems, infection, or chronic health conditions like anemia or asthma. Certain medications, including allergy medications, and mental health conditions like anxiety and depression can also cause fatigue.

4. A Change in Sensations

Your nerves send messages to your brain about what you are feeling. When MS damages these nerves, it can cause unusual sensations. Children with MS may experience:

• Nerve pain
• Numbness
• Itchiness
• Tingling
• “Pins-and-needles” sensations

Other factors like injuries, infections, genetic disorders, surgeries, or medications can also cause changes in how your child’s nerves work.

5. Feeling Sensitive to Heat

Many children with MS struggle with heat or feel unusually hot in warmer temperatures.

Several MyMSTeam members who had MS symptoms as children shared their experience with heat sensitivity. One member said, “I knew as a kid I couldn’t take the heat like most kids.” Another remembered, “Running track, I got overheated and almost passed out.”

6. Vision Problems

When MS affects the optic nerve, which connects the eye to the brain, it can lead to vision problems such as blurry vision, double vision, or even vision loss. If your child has this symptom, you may notice them squinting or sitting closer to the TV.

One MyMSTeam member shared that vision problems were their child’s first symptom: “My daughter first lost her vision in one eye.” Another member had a similar experience. “When my daughter complained of headaches and muscle aches, I gave her a Tylenol and brushed it off until she was losing her vision,” they shared. “That’s when I started to pay attention.”

Vision changes are common in children. About 1 out of 5 kids develop conditions like nearsightedness (trouble seeing far away) or farsightedness (difficulty seeing up close). These conditions can be corrected with glasses or contact lenses, but MS-related vision changes may not improve despite vision correction.

7. A Shift in Bathroom Habits

MS can make it hard for kids to use the bathroom normally. You may notice that your child suddenly asks to use the bathroom more often, has trouble holding urine, or starts wetting the bed again.

“My son had bladder and bowel issues,” wrote one MyMSTeam member.

Some children naturally take longer to learn bathroom control. However, if a child suddenly experiences urinary incontinence after previously having no bladder issues, it may signal an underlying condition like MS — or other conditions such as diabetes, anxiety, sleep disorders, or a urinary tract infection.

8. Changes in Thinking Abilities

MS can affect your child’s ability to:

• Focus or paying attention
• Remember things
• Organize and plan
• Make decisions or solve problems

Children naturally develop these skills at different rates. However, if your child is struggling with these skills or isn’t hitting certain developmental milestones, it’s a good idea to talk to their healthcare team. According to some estimates, around one-third of children with MS may experience cognitive (thinking) problems. Cognitive changes in children can also happen due to learning disorders, mental health conditions, or intellectual disabilities.

9. Mood and Mental Health Symptoms

Some children with MS experience mental health conditions like depression and anxiety. Depression may affect about 1 in 4 children with MS. Mental health issues can affect your child’s quality of life, making it harder to do well in school or participate in activities.

“My daughter was diagnosed at 15 years old,” shared one parent. “Her biggest challenges are fatigue, trouble sleeping, body aches, and anxiety.” “My son is doing well physically, but emotionally, I know he’s a mess,” another member of MyMSTeam said.

Meeting With Your Child’s Healthcare Provider

Always tell your child’s pediatrician about any new symptoms you notice. While your child’s healthcare team can’t come to a diagnosis of MS based on symptoms alone, doctors can rule out other possible conditions. They may use tests such as an MRI to look for signs of damage that could suggest MS. Your child’s doctor may refer you to a specialist, such as a neurologist, to address nervous system problems and create a treatment plan.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 218,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Is your child dealing with multiple sclerosis? What were some of their first symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.