In children and adolescents, multiple sclerosis (MS) has an impact on the developing central nervous system, and can result in transient or fixed deficits of gross motor and/or fine motor skills, sensory perceptual processing, bowel/bladder function, vision, balance, and coordination. In this chapter, the evaluation and care of patients with symptoms of pediatric demyelinating disease are addressed as individual systems with discussion of anatomy and typical features, evaluation measures, and treatment options, including both non-pharmacologic and pharmacologic approaches. Fatigue is the most common symptom experienced by MS patients and is adversely correlated with quality of life. Minimizing fatigue in the pediatric MS population requires a multifaceted approach of eliminating unnecessary energy demands, improving sleep hygiene and optimizing symptomatic medication and disease-modifying treatment (DMT) regimens. The PedsSQ Multidimensional Fatigue Scale has been validated and used in other pediatric chronic diseases such as cancer, inflammatory bowel disease, and rheumatological diseases.

A large part of neurological disabilities of the young adult population of developed countries is due to multiple sclerosis (MS). This chapter focuses on the most prominent features of the etiology, natural history, and treatment of the disease. Hundreds of epidemiological studies on MS prevalence which have been conducted throughout the world provide evidence that the disease involves the interplay of genetic susceptibility factors and environmental exposures, possibly to infectious agents. The diagnosis for MS remains mainly based on clinical data. The expanded disability status scale (EDSS) was devised to evaluate neurological impairment in MS is widely used to describe disease progression in MS patients. Interventions in MS aim to reduce duration and severity of exacerbations, to alter the natural history of the disease, mainly by reducing the relapse rate, or to treat the consequences of neurological disorders including spasticity, chronic pain, or bowel and bladder dysfunction.