CME: Multiple Sclerosis in Pediatric & Pregnant Patients: Challenges in Treatment

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Multiple Sclerosis in Pediatric & Pregnant Patients: Challenges in Treatment

Program Information
Multiple Sclerosis in Pediatric & Pregnant Patients: Challenges in Treatment
Drs. Gold & Krupp review treatment strategies in two challenging multiple sclerosis cases: a pediatric patient and a pregnant patient.

Available credits: 0.25

Time to complete: 15 minutes


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  • Overview

    MS is a challenging chronic disease to manage for any healthcare professional, but the most difficult cases we often face involve children and pregnant women.  Up to 5% of people diagnosed with MS are under the age of 16. The peak age of diagnosis for women falls between 20 and 50 years old; however, that also happens to be the highest fertility window for these patients.  Each of these populations present their own unique challenges, so on today’s program we’re going to focus on the best treatment strategies to overcome these issues for pediatric and pregnant MS patients. 

    Case 1:

    This pediatric case involves a 7-year-old boy who develops a URI and two weeks later becomes lethargic, followed by ataxia. He presents at the ER where he was afebrile, sleepy, and unable to walk unassisted. 

    Case 2:

    This patient is a 27-year-old, married mother of a 4-year-old boy presenting with optic neuritis, and numbness and tingling in her legs.  She’s given a diagnosis of MS and placed on a first-line classic agent, interferon beta-1a.  After 2 months, the patient learns she is pregnant.  

  • Disclosure of Conflicts of Interest

    In accordance with the ACCME Standards for Commercial Support, The Omnia-Prova Education Collaborative (TOPEC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TOPEC resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.

    David Weisman, MD
    Director of Clinical Trials, Neurologist
    Abington Neurological Associates
    Abington, PA

    Dr. Weisman has disclosed that he conducts contracted research for Acadia, Avanir, Axovant, Biogen, Biotie, Boeringher, Eli Lilly, Eisai, Genetech, Grunenthal, Janssen, Merck, Pfizer, Novartis, and Roche. 


    Lauren B. Krupp, MD
    Director, MS Division
    NYU Langone Health
    New York, NY

    Dr. Krupp has disclosed that she is a consultant for Biogen, Everyday Health, Gerson Lehman, RedHill Biopharma, Roche, Sanofi-Aventis, and Shire; an advisory board member for Biogen and Novartis Pharma AG; and receives royalties from AbbVie Pharmaceuticals, Amicus Therapeutics, Atara Biotherapeutics Inc., Biogen, Eisai, ERT Inc., Finkhar Health, IPSOS, Janssen Pharmaceuticals, Merck, Octapharma, Pfizer, Reata Pharma USA, Research Tech, and SA Inventions.

    Prof. Ralf Gold, MD
    Professor and Department Chair
    St Josef Spital; Ruhr University Bochum
    Bochum, Germany

    Dr. Gold has disclosed that he receives a consulting fee from Biogen, Sanofi, Bayer, TEVA, Roche, Novartis; conducts contracted research with Biogen and Novartis; and owns stock from Roche and Merck. 


    • Sean Barrett has nothing to disclose.
    • Carole Drexel, PhD has nothing to disclose.
    • Ann Early has nothing to disclose.
    • Barry A. Fiedel, PhD has nothing to disclose.
    • John D. Hixson, MD has disclosed that he conducts contracted research for UCB, INC.
    • The PIM planners and managers have nothing to disclose.
  • Learning Objectives

    After participating in this educational activity, participants should better be able to:

    • Integrate safety and adherence considerations, in addition to efficacy, into immediate and longer-term therapeutic decisions for pediatric patients with MS.
    • Employ management options to control MS symptoms in pregnant women while reducing the risk of adverse pregnancy outcomes.
  • Target Audience

    This activity is designed to meet the educational needs of practicing neurologists, advanced practice nurses, and other healthcare professionals that treat patients with multiple sclerosis.

  • Fee Information

    There is no fee for this educational activity.

  • Accreditation and Credit Designation Statements

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of The Omnia-Prova Education Collaborative (TOPEC) and Postgraduate Institute for Medicine (PIM). TOPEC is accredited by the ACCME to provide continuing medical education for physicians.

    The Omnia-Prova Education Collaborative, Inc., designates this enduring material for a maximum of .25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Joint Accreditation Statement 

    In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and ASiM. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours. Designated for 0.1 contact hours of pharmacotherapy credit for Advanced Practice Registered Nurses.

    Interprofessional Continuing Education 

    This activity was planned by and for the healthcare team, and learners will receive 0.2 Interprofessional Continuing Education (IPCE) credit for learning and change

    The American Medical Association has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries. Physicians interested in converting AMA PRA Category 1 CreditsTM to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMECs) should contact the UEMS at

  • Provider

    TOPEC Global designs educational activities based on evidence-based medicine, needs and gaps analyses, learner feedback, and more. Its mission is to serve as an innovative and relevant resource for clinical content and educational interventions across a broad spectrum of specialties.

  • Commercial Support

    This activity is supported by an independent educational grant from Merck KGaA, Darmstadt, Germany.

  • Disclaimer

    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of TOPEC, TOPEC Global, and Global Neurology Academy. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of TOPEC Global and Global Neurology Academy, you are subject to the terms and conditions of use, including copyright and licensing restriction, of that site.

    Reproduction Prohibited

    Reproduction of this material is not permitted without written permission from the copyright owner.

    Disclaimer: Some products discussed in this activity have not received regulatory approval by the US FDA for the treatment of patients with Multiple Sclerosis. The FDA has stated that “good medical practice and the best interests of the patient require that physicians use legally available drugs, biologics and devices according to their best knowledge and judgement."

  • System Requirements

    Our site requires a computer, tablet or mobile device and a connection to the Internet. For best results, a high-speed Internet connection is recommended (DSL/cable). We also recommend using the latest version of your favorite browser to ensure compliance with W3C standards, such as Internet Explorer, Microsoft Edge, Chrome, Firefox or Safari. Users accustomed to IE8, IE9 IE10 are advised to update their browsers for the best experience.

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