The purpose of this term paper is twofold. First, it allows the student to become better acquainted with a specific medical research topic. Second, by writing the paper the student acquires important skills in searching for and critically appraising research literature. In this paper, I review research publications about a relatively narrow research field concerning instances of multiple sclerosis (MS) among children. More specifically, I ask how to treat MS in children under the age of 16, and what we know about this topic today. I also ask whether the progression of the disease differs between adults and children. Finally, I ask whether children and adults require the same kind of treatment.
To answer the questions, I made an initial search on the medical research search engine, MEDLINE, resulting in a pile of 449 articles related to the topic. After narrowing down the search, using the criteria of a) patients’ age (16 or less), b) duration of treatment (minimum 6 months), c) language (the articles had to be in English) and d) that the article was electronically available at the library. I ended up with nine research articles.
According to todays knowledge, MS mainly strikes adults between 20 and 40 years of age, but the disease also strikes older people and children. Some cautious studies suggest that 5 % of the MS population is children under the age of 16. Yet, it is fair to assume that there is a certain degree of underreporting since systematic research on MS among children is limited due to ethical considerations. Existing research on treatment of pediatric patients are generally positive and indicate that immunomodulating treatment has a benign effect on children and that there are few negative side-effects. Yet, there is very little knowledge about how the disease progresses over time and about whether initial positive effects from the treatment will endure over time. For this reason, all papers reviewed in this paper emphasise the importance of long-term treatment and follow up. Since ethical considerations limit the range of methodological tools available to researchers in this field, it is difficult to give a thorough evaluation of the quality of the reviewed studies. The kind of randomised, controlled studies that underlie studies of MS among adults have so far not been conducted among pediatric patients. By contrast, all the reviewed studies are based on case studies. These do not yield generalisable results but only examples of how the disease and the treatment might co-evolve in certain instances. Writing this term paper has been an inspiring experience and I feel I have gained a relatively good overview of this particular research field. More importantly, however, writing this paper makes me better prepared for searching out and evaluating up-to-date knowledge about other research topics. This, I believe will turn out highly valuable in my future practice as a medical doctor.