Diagnosing Multiple Sclerosis in Children

Doctors at Hassenfeld Children’s Hospital at NYU Langone have the experience necessary to offer expert diagnosis of all types of multiple sclerosis, or MS, in children. Diagnosing MS in children and teens is challenging, because similar symptoms are seen in other neurological conditions, such as acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica.

In people with MS, the protective coating surrounding nerves of the central nervous system, which is made up of the brain and spinal cord, is damaged by the body’s own immune system. This damage leads to scarring in the form of lesions—also called sclerosis—that affect the nerve signals sent between the brain and spinal cord and the rest of the body.

Weakness, vision changes, fatigue, numbness, and muscle spasms are some of the most common initial symptoms of MS in children. Less frequently, seizures occur with MS. This symptom may be more common in children than in adults with multiple sclerosis.

Medical History and Neurological Exam

Your doctor asks detailed questions about your child’s medical history and symptoms before performing a neurological examination. During this exam, the doctor evaluates your child’s movement, coordination, and balance, as well as vision and sensation.

A neurological exam helps the doctor determine if there is impairment in the central nervous system. It also helps to rule out other neurological diseases that may affect the nerves or muscles.

If a child has had two separate neurological attacks—for example, blurry vision followed by numbness a few years later—and imaging scans reveal two or more lesions on the brain, no further testing is required to make a diagnosis of MS. However, a child’s neurological history is not always clear, and often doctors need to perform additional tests to make a definitive diagnosis.

Blood Test

Your child’s doctor may obtain a sample of blood, which is sent to a laboratory for testing in order to rule out other conditions with symptoms that mimic MS. These conditions include lupus, sarcoidosis, and neuromyelitis optica. Behcet’s disease is another condition that affects the neurological system and has symptoms that may resemble those of MS.

MRI Scans

If your child is experiencing neurological symptoms that suggest MS, the doctor may order an MRI scan, in which magnetic waves and computers create images of the body’s tissues and structures. This allows doctors to see inside the brain and spinal cord and to identify any areas of scarring caused by MS.

Doctors may give your child a dye through a vein with intravenous (IV) infusion before the scan. The dye highlights any abnormalities and can help the doctor to identify lesions.

MRI scans are performed at Hassenfeld Children’s Hospital. If an MRI reveals the presence of lesions typical of MS, your child’s doctor does not need to order additional tests to make a diagnosis.