Journal of Neurology and Neurorehabilitation Research

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Opinion Article - Journal of Neurology and Neurorehabilitation Research (2024) Volume 9, Issue 3

Current Approaches to Managing Pediatric Multiple Sclerosis

Nadine Gross *

Department of Pediatrics, University of Calgary School of Medicine, Germany

*Corresponding Author:
Nadine Gross
Department of Pediatrics, University of Calgary School of Medicine, Germany
E-mail: ngross@cu.ger.com

Received: 29-Apr-2024, Manuscript No. JNNR-24-137853; Editor assigned: 30-Apr-2024, PreQC No. JNNR-24-137853 (PQ); Reviewed: 15-May-2024, QC No. JNNR-24-137853; Revised: 20-May-2024, Manuscript No. JNNR-24-137853(R); Published: 27-May-2024, DOI: 10.35841/aajnnr-9.3.210

Citation: : Gross N. Current Approaches to Managing Pediatric Multiple Sclerosis. J Neurol Neurorehab Res.2024;9(3):210

Introduction

Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system (CNS). While it is more commonly diagnosed in adults, pediatric multiple sclerosis (PMS) accounts for approximately 3-10% of all MS cases [1].

Managing PMS presents unique challenges due to the developing nervous system and the long-term impact on a child’s growth and development. This article explores the current approaches to diagnosing, treating, and managing PMS [2].

The primary goals in managing PMS are to reduce the frequency and severity of relapses, delay disease progression, manage symptoms, and improve quality of life. Current treatment strategies include: Disease-Modifying Therapies (DMTs): Interferon-beta: Reduces the frequency of relapses and MRI lesion activity. Common side effects include flu-like symptoms and injection site reactions [3].

Glatiramer acetate: Modulates the immune response to reduce relapses. It is generally well-tolerated with minimal side effects. Oral DMTs: Fingolimod, teriflunomide, and dimethyl fumarate are approved for use in adults and are increasingly being used off-label in children. These medications offer the convenience of oral administration but require monitoring for potential side effects such as lymphopenia and liver enzyme abnormalities [4].

Monoclonal antibodies: Natalizumab and ocrelizumab are used in more severe cases. These therapies target specific components of the immune system to reduce inflammation and disease activity. Corticosteroids: High-dose intravenous methylprednisolone is the standard treatment for acute relapses. It helps reduce inflammation and hasten recovery. Oral prednisone tapering may follow the intravenous course [5].

Fatigue: Medications such as amantadine and modafinil, along with lifestyle modifications, can help manage fatigue. Spasticity: Muscle relaxants like baclofen and tizanidine can reduce muscle stiffness and spasms [6].

Pain management: Neuropathic pain can be managed with medications such as gabapentin, pregabalin, or amitriptyline. Bladder and bowel dysfunction: Anticholinergic drugs for bladder control and dietary modifications or laxatives for bowel management. Cognitive impairment: Cognitive rehabilitation and educational support are essential to help children cope with cognitive deficits [7].

Regular Follow-up: Neurological assessments: Regular visits to a neurologist to monitor disease progression and response to treatment. MRI scans: Periodic MRI scans to assess disease activity and adjust treatment accordingly [8].

Multidisciplinary Approach: Comprehensive care: Collaboration among neurologists, pediatricians, physical therapists, occupational therapists, psychologists, and educators to provide holistic care. Family involvement: Active involvement of the family in the care plan to ensure adherence to treatment and support for the child [9].

Ongoing research aims to develop new treatments and improve outcomes for children with PMS: New DMTs: Clinical trials are exploring the safety and efficacy of newer DMTs specifically for pediatric use. Biomarkers: Research on biomarkers to predict disease progression and response to therapy, enabling more personalized treatment approaches. Neuroprotective therapies: Investigating therapies that protect neurons from damage and promote repair, potentially altering the disease course [10].

Conclusion

Managing pediatric multiple sclerosis requires a comprehensive, multidisciplinary approach that addresses both medical and psychosocial aspects of the disease. Current treatment strategies focus on disease-modifying therapies to reduce relapses and slow progression, symptomatic treatments to improve quality of life, and supportive care to address psychological, educational, and social needs. Advances in research and emerging therapies hold promise for further improving outcomes and quality of life for children with PMS. By adopting a holistic and individualized approach, healthcare providers can help children with PMS lead fulfilling lives despite the challenges posed by this chronic condition.

References

  1. Wang CX. Assessment and management of acute disseminated encephalomyelitis (ADEM) in the pediatric patient. Pediatric Drugs. 2021;23(3):213-21.

    2. Indexed at. Google Scholar, Cross Ref

  2. Yeh EA. Diagnosis and treatment of multiple sclerosis in pediatric and adolescent patients: current status and future therapies. Adolesc Health Med Ther. 2010:61-71.

    3. Indexed at. Google Scholar, Cross Ref

  3. Konuskan B, Anlar B. Treatment in childhood central nervous system demyelinating disorders. Dev Med Child Neurol. 2019;61(11):1281-8.

    4. Indexed at. Google Scholar, Cross Ref

  4. Bild W, Vasincu A, Rusu RN, et al. Impact of the renin-angiotensin system on the pathogeny and pharmacotherapeutics of neurodegenerative diseases. Biomolecules. 2022;12(10):1429.

    5. Indexed at. Google Scholar, Cross Ref

  5. Mogavero MP, Lanza G, Bruni O, et al. Sleep counts! Role and impact of sleep in the multimodal management of multiple sclerosis. J Neurol. 2023;270(7):3377-90.

    6. Indexed at. Google Scholar, Cross Ref

  6. Etta I, Elballushi R, Kolesnyk V, et al. Comparison of Pharmacological Therapies in Relapse Rates in Patients With Relapsing-Remitting Multiple Sclerosis. Cureus. 2023;15(9).

    7. Indexed at. Google Scholar, Cross Ref

  7. Stucklin AS, Tabori U, Grotzer MA. The changing landscape of pediatric low-grade gliomas: clinical challenges and emerging therapies. Neuropediatrics. 2016:070-83.

    8. Indexed at. Google Scholar, Cross Ref

  8. Thompson AJ, Chandraratna D. Multiple Sclerosis International Federation: stimulating international cooperation in research. Neurology. 2013;81(20):1793-5.

    9. Indexed at. Google Scholar, Cross Ref

  9. Sahoo SS, Kobow K, Zhang J, et al. Ontology-based feature engineering in machine learning workflows for heterogeneous epilepsy patient records. Sci Rep. 2022;12(1):19430.

    10. Indexed at. Google Scholar, Cross Ref

  10. Chugani HT. The role of PET in childhood epilepsy. J Child Neurol. 1994;9(1):82-8.

    11. Indexed atx. Google Scholar, Cross Ref

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