Multiple sclerosis (MS) is a chronic condition that can change over time. When new symptoms develop or known symptoms get worse, it’s known as a flare, attack, relapse, or exacerbation.

If your child lives with MS, they may experience mild flares that go away on their own or more severe flares that require treatment. In most cases, flares are mild. In rare cases, your child may need to visit the emergency department or urgent care center.

Keep reading to learn more about severe flares and when you should consider taking your child to the hospital for treatment.

Most MS flares don’t require a trip to the emergency department to treat.

But sometimes MS-related symptoms do require immediate treatment. There may also be cases when your child’s flare is triggered by a serious infection that requires immediate attention.

If your child has MS, they might be experiencing a medical emergency if they develop:

  • sudden vision loss
  • sudden leg weakness that affects their mobility
  • intense pain that prevents them from functioning well
  • changes in their symptoms that are accompanied by a fever or other signs of infection
  • trouble or pain with urination
  • high fever

If your child experiences any of these symptoms or other signs of a severe flare, contact their neurologist or other members of their MS health team.

They can help you determine whether your child should visit the emergency department, an urgent care center, or the neurologist’s office for treatment.

If your child is having trouble breathing or shows signs of reduced consciousness, call 911 immediately.

To treat severe flares of MS, doctors often prescribe a short course of corticosteroids. In some cases, they may also prescribe other treatments.

Corticosteroids

If your child experiences a severe MS flare, corticosteroids can help reduce inflammation and speed up the recovery process.

Their doctor may prescribe treatment with an oral steroid, such as oral methylprednisolone. Or they may prescribe treatment with an intravenous corticosteroid, such as IV methylprednisolone.

Short-term corticosteroid use can cause side effects, such as:

  • upset stomach
  • increased appetite
  • difficulty sleeping
  • mood changes
  • headache
  • rash

Long-term corticosteroid use can cause more serious side effects and should be avoided.

Plasma exchange

If your child’s symptoms don’t respond to treatment with corticosteroids, their doctor may recommend plasma exchange. This procedure is also known as plasmapheresis.

To perform plasma exchange, a healthcare professional will remove some of your child’s blood from their body. A machine will separate your child’s blood cells from the liquid portion of their blood, known as plasma.

Your child’s blood cells will then be transfused back into their body, along with donor plasma or a plasma substitute.

Potential side effects of this procedure include infection and blood clotting problems.

Always let your child’s neurologist and other members of their health team know if your child has been admitted to a hospital for MS-related symptoms.

Their health team may recommend follow-up care, including rehabilitation therapy, medications, or other treatments.

If a severe flare has negatively affected your child’s physical or cognitive abilities, their health team may recommend rehabilitation therapy to help your child recover or adapt.

For example, they may recommend:

  • occupational therapy, if your child is finding it hard to complete routine tasks at school or home
  • physical therapy, if your child is having trouble moving or getting around
  • speech-language therapy, if your child is experiencing difficulties with speech or swallowing
  • cognitive remediation, if your child is coping with thinking or memory problems

Your child might need to take time off school or make other adjustments to their daily routine while recovering from a severe flare.

If your child develops new symptoms during a flare, their health team may prescribe medications to help manage those symptoms.

For example, they may prescribe medications to help treat:

  • pain
  • fatigue
  • bladder problems
  • bowel problems

To help prevent future flares, your child’s doctor might also prescribe a disease-modifying therapy (DMT).

The Food and Drug Administration (FDA) hasn’t approved any DMTs for children under 10 years old. However, neurologists sometimes prescribe DMTs to younger children. This is known as “off-label” use.

Most MS flares can be treated outside of a hospital. In some cases, your child might need to visit an emergency department or urgent care center.

If you suspect that your child is experiencing a severe flare, contact their neurologist or other members of their MS health team. They can help you learn where to get the treatment your child needs.

If your child is having difficulty breathing or losing consciousness, call 911 right away.