In the last 15 years of international and cooperative studies has been identified an increased number of genetic and environmental risk factors for MS in children, which contributed to a better understanding of the pathophysiology of MS. As risk factors of MS in children are considered puberty and sex hormones, obesity, vitamin D, exposure to viruses, smoking, diet composition and genetic factors.
The diagnosis must be extended to exclude other iflammatory diseases. Not every demyelinating event in children develops to MS.
Careful differential diagnosis is required. Treatment of clinically isolated syndrome or acute exacerbation-relapse of MS in children is based on the experience of treatment in adults.
The lack of efficacy of first-line treatmen twith disease modifying drugs (DMD) requires escalation of more than 40% of pediatric patients. An inseparable part of the treatment of MS in children and adolescents is symtomatic and non-medicamentous treatment.