Multiple sclerosis from a kid's perspective
Multiple sclerosis (MS) is not just for adults. In fact, this debilitating disease has been diagnosed in children as young as two years old. But thanks to the pioneering work of researchers like Dr. Brenda Banwell, children with MS have a much brighter future.
Because MS is a disease that is typically diagnosed in young adults, most MS treatments are designed for adult patients. The youngest patients with MS were frequently misdiagnosed or shoehorned into adult treatment programs. However, in 1999, the Toronto chapter of the MS society and the Hospital for Sick Children (Sick Kids) recruited Dr. Brenda Banwell to help set up a new clinic for kids with MS.
"The MS society in Toronto asked me to take on the care of five children with pediatric onset MS," recalls Dr. Banwell. "In doing that, I started to explore what was known about pediatric MS care and discovered that there really wasn't comprehensive care for kids with MS anywhere."
Since Dr. Banwell and her colleagues started the clinic, they have helped lay the groundwork for better diagnosis and treatment of MS in children. They helped establish a database to monitor the number of children with the disease and the symptoms they experience; they put together a care team that included physiotherapists, occupational therapists, psychologists and pediatric nurses certified to treat MS patients; and they helped determine how to safely administer adult medications to children with MS.
With the help of the MS Society of Canada, the Multiple Sclerosis Scientific Research Foundation, and Canadian Institute of Health Research (CIHR), this pediatric MS clinic has also deepened researchers' understanding of the disease.
"If you study patients earlier in their disease you can learn something about how the disease begins," explains Dr. Banwell. "Often when an adult is diagnosed with MS, they've already been experiencing symptoms for years. By looking at the youngest MS patients, we hope to gain some insights into the earliest changes that occur in the immune system in this disease."
Dr. Banwell's team has focussed much of their research on the effects that MS has on the developing brain. They are trying to determine whether childhood MS attacks, which strike during the delicate time when the myelin coating on nerve cells is still being formed, can create lasting deficits. So far Dr. Banwell's research has revealed that 40-50% of children with MS have some cognitive difficulties, particularly when it comes to multitasking and accessing short-term memories.
Dr. Banwell also hopes that the research at the Sick Kids clinic can help untangle the complicated interaction of genetic and environmental factors that potentially cause MS.
"If there is an important environmental trigger for this disease, it probably has the greatest impact during childhood," explains Dr. Banwell. "Also, people with early onset forms of MS probably have the greatest genetic predisposition to the disease, so they can help us figure out what role genetics plays."
Compliments of:
Multiple Sclerosis Society of Canada
Institue of Neurosciences, Mental Health, and Addiction (INMHA)
Canadian Institutes of Health Research