Multiple sclerosis in children and adolescents

Multiple sclerosis (MS) is considered to be a disease of young adulthood, b ut it should be noted that cases in childhood and adolescence are not rare. Principally, childhood MS and MS in the adult age are the same disease. Ne vertheless, there are some important differences concerning possible differ ential diagnoses, symptoms, clinical course and therapy. Of special interes t is the fact that the prognosis of MS in childhood seems to be better than that of MS in the adult age, partially as a consequence of the lower perce ntage of primary and secondary progressive courses. Despite the fairly good prognosis of childhood MS, a consequent immunosuppressive treatment of acu te attacks as well as a timely immunomodulatory therapy to slow down the pr ogression of the disease is to be recommended. Yet the potential therapeuti c benefit of such a treatment has to be carefully balanced against the pres ently unknown long-term risks of an immunomodulation early in life. Additio nally, pharmacotherapy of childhood MS should always be part of a comprehen sive therapeutic concept also considering physiotherapeutic and individual psychosocial care.