Multiple sclerosis (MS) is a condition in which the immune system damages 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 developed symptoms before they turned 18, and fewer than 1 in 100 develop symptoms before the age of 10. Among adults and children, MS is more common among females than males.

MS Symptoms in Children and Adolescents

MS symptoms can be hard to identify because they frequently change. For example, your child may experience one symptom this week and a completely different symptom the next, as new lesions (areas of damage) develop in different parts of the body. Additionally, each symptom may gradually improve or worsen over time.

Pediatric-onset MS typically leads to the same MS symptoms as adult-onset MS. 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 similar symptoms, one clue that your child may be experiencing MS is that their symptoms go away for a while and then return.

Below are some common childhood MS symptoms. Your child may have one or some of these, or they may experience other issues. None of these symptoms are diagnostic of MS, however: Other diseases can cause these symptoms. A doctor will only make an MS diagnosis if they find evidence of multiple lesions (or plaques) in the CNS through an MRI scan and that the disease progresses over time.

Balance Problems

Although people of all ages with MS may experience balance difficulties, this symptom is more common in children than adults. As a result of this symptom, your child may:

• Move more slowly
• Look wobbly as they walk
• Hold onto nearby items as they move
• Feel dizzy

Many MyMSTeam members have said they now realize they had 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 potential causes of balance difficulties include:

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

Muscle Problems

Pediatric MS symptoms include muscle weakness, tremors, and spasticity (tightness or stiffness). In some cases, the muscles may suddenly stop moving the way they normally do. MS can also lead to a lack of coordination. This common symptom also affects children with MS more frequently than adults.

If your child has muscle symptoms, you may notice that they frequently drop objects or suddenly have trouble writing or drawing. Your child may not be able to move normally or perform the activities they used to.

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

Another member shared 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 commented.

Tiredness

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

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

Your child may also feel tired if they are dealing with an infection, have a chronic health condition like anemia or asthma, or are taking certain drugs including allergy medications. Mental health conditions like anxiety and depression can also cause fatigue.

A Change in Sensations

Your nerves provide information 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

Injuries, infections, genetic disorders, surgeries, or medication can also lead to changes in the way your child’s nerves function.

Feeling Sensitive to Heat

Many children with MS have a hard time tolerating warmer temperatures or often feel unusually hot.

Several MyMSTeam members who had MS symptoms as children said they experienced heat sensitivity. “I knew as a kid I couldn’t take the heat like most kids,” commented one member. “I remember running track,” remarked another. “I got overheated and almost passed out.”

Vision Problems

When MS affects the optic nerve, which connects the eye to the brain, this can lead to symptoms such as blurry vision, double vision, vision loss, or other issues with seeing normally. If your child has this symptom, you may notice them squinting or sitting closer than usual to the TV.

One MyMSTeam member wrote that vision problems were their child’s initial symptom: “My daughter first lost her vision in one eye.” Another had a similar experience. “When my daughter would complain 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 things started to get my attention.”

Vision changes are common in children. About 1 out of 5 kids develop conditions like nearsightedness (trouble seeing faraway objects) or farsightedness (difficulty seeing close-up objects). These conditions can be corrected with glasses or contact lenses, whereas MS-related vision changes may linger despite vision correction.

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 in urine, or goes back to wetting the bed.

“My son had problems with passing blood and, of course, the bladder and bowel issues,” wrote one MyMSTeam member.

Some children naturally develop more slowly and have a harder time learning to control their bathroom habits. However, if a child suddenly experienced urinary incontinence after previously being able to control their bladder, it may signal an underlying condition like MS — or other conditions, including diabetes, anxiety, sleep disorders, or a urinary tract infection.

Changes in Thinking Abilities

MS can lead to problems with:

• Focusing or paying attention
• Remembering things
• Organizing and planning
• Making decisions or thinking through problems

Children naturally have different abilities in these areas. However, if your child isn’t hitting certain developmental milestones, you may want to talk to your child’s health care team. Children with MS are more than 3.5 times more likely to experience cognitive (thinking) problems, and these issues often start at a young age. Cognitive changes can also happen due to a learning disorder, a mental health condition, or an intellectual disability.

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 good physically, but emotionally I know he’s a mess,” a member of MyMSTeam mentioned.

Meeting With Your Child’s Doctor

Always tell your pediatrician about any new symptoms that you notice in your child.

Your child’s health care team can’t come to a diagnosis of MS based on symptoms alone. However, they can rule out other potential conditions and use tests such as an MRI to look for signs of damage that help signal MS. Your child’s doctor may refer you to a specialist such as a neurologist to further address nervous system problems and come up with 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 196,000 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 pediatric multiple sclerosis? What were some of their initial symptoms? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.