December 4, 2002, Wednesday
Kyle Wallace, age 9, loves to play football with his dad.
That's not unusual for a second-grade boy, but Wallace has multiple sclerosis, the neurological disease once thought to strike adults only. Researchers in a few medical centers in the USA and Canada say they're seeing more children like Kyle who are diagnosed with the disease.
And the last thing the young patients want to think about is a disease that can cause unpredictable bouts of paralysis, numbness, vision loss and a host of other terrifying symptoms.
MS affects about 350,000 American adults, and experts estimate that as many as 20,000 children in the USA have the disease but are undiagnosed. New medical evidence suggests that the number of pediatric patients is rising -- probably because more doctors are considering the diagnosis when they see a child suffering from telltale symptoms such as a sudden loss of vision. When a childhood diagnosis is made, doctors, parents and children are faced with a number of unanswered questions. Researchers don't know whether the drugs used to treat adults will work for children. They don't know how quickly the disease will progress.
MS occurs when the body's immune cells turn and mistakenly attack the thick sheath covering the nerve fibers of the brain and spinal cord. This protective coating, myelin, is like the rubber insulation on an electrical wire. When it's stripped, the nerve can be damaged, triggering a range of symptoms such as tremors or slurred speech. But the course of MS doesn't follow a predictable pattern.
Some people with MS have attacks that can last several days to a week and then fully recover. They may not get another attack for a year or even a decade. Others will get several attacks spaced out over a year. A small number of people with MS get steadily worse with each attack.
Into the unknown
But that's the way the disease progresses for adults. No one knows what will happen to kids like Kyle. Lauren Krupp at the State University of New York-Stony Brook and her colleagues just completed a study of 21 kids with MS, one of the first studies to focus on the disease in children.
Traditionally, neurologists had been taught that MS strikes adults, most often women, between the age of 20 and 40. But Krupp's study, sponsored by the National Multiple Sclerosis Society, suggests MS can launch its attack very early in life: One child in the study was diagnosed at 6.
Other researchers say they've seen the disease in preschool children. Brenda Banwell, a neurologist at the Hospital for Sick Children in Toronto, says her team has treated 34 children with MS: The youngest was 4 and nearly half were under age 10 when they had their first attack.
Kyle Wallace had his first MS attack at age 4, says his mother, Tammy. She was getting him ready to go to preschool in the morning when suddenly he couldn't sit up.
Even today, many doctors don't consider MS a possibility in a child that young, Banwell says. In fact, Tammy Wallace says she has tried to get help at the local hospital when Kyle has an attack, only to be told there's no such thing as pediatric MS.
Now she doesn't even try to get help in their suburb outside Toronto. She drives the 45 minutes to get to Toronto's Hospital for Sick Kids.
That lack of knowledge about pediatric MS means many kids may not get a diagnosis right away. Only a few doctors at urban centers in the USA and Canada specialize in pediatric MS. Krupp's group gets kids from all over the USA. Banwell's group in Toronto also sees families from all over Canada and even some from the USA.
Suffering in silence
Except for some mild tremors, no one would ever guess that 17-year-old Anna Peabody has MS. But Peabody, an honors student at Acton-Boxborough Regional High School in Acton, Mass., has lived through five flare-ups in the disease since her diagnosis in 2001.
"It's been awful," she says. "I missed three months of school last year." Peabody made up that time during the summer and went on with her classmates.
But researchers can't tell Peabody what the future might hold. "I worry," she says simply. "Will I be able to walk when I am 20?"
Although most children with MS have very mild cases, both Krupp and
Banwell have seen a small group of kids with very aggressive symptoms.
Instead of one or two attacks a year, these children must deal with five
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