ONCE THE DIAGNOSIS of MS has been established, the doctor will likely recommend treatment with one of the disease modifying therapies that have been approved by FDA and/or Health Canada. These medications, while not specifically approved for use in children, appear to be safe and well-tolerated in individuals under the age of 18. They are increasingly being prescribed to youngsters with MS based on physicians' shared clinical experience, but opinions among doctors regarding which medication to use vary greatly. Once again, this means that parents might hear very different recommendations from different doctors.
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| Multiple Sclerosis Treatment Options |
Few doctors would disagree with the statement that medicine - and particularly the treatment of MS - is as much art as science, and this is particularly true in the treatment of children with MS. Your child's healthcare team will work with you and your child to identify the best treatment options, given your child's particular history and symptoms, and make changes as necessary as time goes on.
Unfortunately, the primary treatment options at this time are all long-term, injectable medications. Receiving or giving oneself the injections on a regular basis is challenging for anyone - adult or child - particularly since these medications do not relieve symptoms or make a person feel better. The injectables are designed to reduce the number and severity of attacks, and slow disease progression, and must therefore be used on a consistent basis, regardless of how the person is feeling at the time. Parents often find it difficult to explain to children and teens why it is essential to take a medication that causes discomfort going in and does not make a person feel better once it is there. And, long, term therapy is a very difficult concept for youngsters to understand, since they are more used to taking a medication (e.g., an antibiotic for strap throat or an ear infection), that solves the problem after several days (and may even taste good).
Dealing with a Relapsing-Remitting Disease
THE VAST MAJORITY of people with MS begin with relapsing remitting course. This means that the person experiences acute, time-limited attacks (also called relapses, exacerbations, flare ups), which are defined as the appearance of new symptoms or the worsening of existing symptoms, lasting at least 24 hours. To be a true attack, the episode must also be separated from the prior attack by at least one month. The attacks (which may or may not be treated with a short course of high-dose corticosteroids) are generally associated with inflammation in the brain or spine cord. Once the attack subsides, the symptoms may disappear entirely, or the person may be left with some residual problems. During the time between attacks, however, the MS is stable, with no evidence of progression.
Although the attacks of MS come and go, the disease-modifying treatments need to continue without interruption in order to be effective. This can pose a significant challenge for parents and children. No child likes to take medication when he or she is feeling fine (e.g., between attacks). During these periods of remission, particularly if all the symptoms have subsided, it is virtually impossible for youngsters (and often their parents) to believe that the MS is still invisibly active inside the body. Everyone wants to get on with normal life, forgetting about the disease for a while - even believing that it has disappeared once and for all; regular injections are an uncomfortable reminder. Since remissions can last for months, helping children understand why they need to continue taking their injections can be quite difficult.
Parents and healthcare providers need to work together to support adherence to the treatment plan. To find out more, you can check out Multiple Sclerosis Treatment Options.