Management of children with multiple sclerosis

The care of children and adolescents with multiple sclerosis (MS) requires appreciation of the impact of the disease on the developing brain and, in particular, the risk for cognitive impairment and academic challenges. Relapse rates in the first three years from onset are high, with an average of 1.5 relapses per year, and often require hospitalization for acute corticosteroid therapy. Disease modulatory therapies are typically prescribed, although formal clinical trials in the pediatric MS population are only just now being realized. In this review, we discuss strategies to optimize therapy for an individual child or teenager, including utilization of a multidisciplinary approach to care.