Symptomatic Management

doi:10.1017/9781108907484.010

Chapter 9 - Symptomatic Management

Published online by Cambridge University Press: 10 February 2021

Andrew Smith and

Carlos A. Perez: Affiliation:
University of Texas, Houston
Andrew Smith: Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson: Affiliation:
University of Minnesota, Minneapolis

Book contents

Get access

Summary

Symptoms of multiple sclerosis (MS) vary considerably from person to person and change over time. Most of these symptoms can be alleviated, but very few can be eliminated completely. Not all symptoms associated with MS are directly related to inflammation of the central nervous system. Although treatment of the disease itself is of major importance, treatment of secondary symptoms is equally important, as failure to do so can compromise quality of life for both patients and their families. In this chapter, we discuss the most common MS-related symptoms and their management. It is important to keep in mind that all treatments used have the potential for side effects. For some symptoms, nondrug approaches are the best initial approach to treatment. Potential difficulties associated with some forms of treatment are also discussed.

Information

Type: Chapter
Information: Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
, pp. 157 - 176
DOI: https://doi.org/10.1017/9781108907484.010 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Yang, CC. Bladder management in multiple sclerosis. Phys Med Rehabil Clin North Am. 2013;24(4):673–86. https://doi.org/10.1016/j.pmr.2013.06.004 CrossRef Google Scholar PubMed

Fowler, CJ, Panicker, JN, Drake, M, et al. A UK consensus on the management of the bladder in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009;80(5):470–7. doi:10.1136/jnnp.2008.159178Google Scholar

Kragt, JJ, Hoogervorst, ELJ, Uitdehaag, BMJ, Polman, CH. Relation between objective and subjective measures of bladder dysfunction in multiple sclerosis. Neurology. 2004;63(9):1716–8. doi:10.1212/01.WNL.0000143062.43325.C8CrossRef Google Scholar PubMed

Chataway, J, Schuerer, N, Alsanousi, A, et al. Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, Phase 2 trial. Lancet. 2014;383(9936):2213–21. doi:10.1016/S0140-6736(13)62242-4Google Scholar

Frohman, TC, Castro, W, Shah, A, et al. Symptomatic therapy in multiple sclerosis. Ther Adv Neurol Disord. 2011;4(2):83–98. doi:10.1177/1756285611400658CrossRef Google Scholar PubMed

DasGupta, R, Fowler, CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis. Drugs. 2003;63(2):153–66. doi:10.2165/00003495-200363020-00003CrossRef Google Scholar PubMed

Rosti‐Otajärvi, EM, Hämäläinen, PI. Neuropsychological rehabilitation for multiple sclerosis. Cochrane Database Syst Rev. 2014;(2). doi:10.1002/14651858.CD009131.pub3Google Scholar

Krupp, LB, Christodoulou, C, Melville, P, et al. Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology. 2004;63(9):1579–85. doi:10.1212/01.WNL.0000142989.09633.5AGoogle Scholar

Patti, F. Treatment of cognitive impairment in patients with multiple sclerosis. Expert Opin Investig Drugs. 2012;21(11):1679–99. doi:10.1517/13543784.2012.716036CrossRef Google Scholar PubMed

He, D, Zhang, Y, Dong, S, et al. Pharmacological treatment for memory disorder in multiple sclerosis. Cochrane Database Syst Rev. 2013;(12). doi:10.1002/14651858.CD008876.pub3Google Scholar

Langdon, DW, Amato, MP, Boringa, J, et al. Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS). Mult Scler. 2012;18(6):891–8.Google Scholar

Feinstein, A. Multiple sclerosis, disease modifying treatments and depression: a critical methodological review. Mult Scler J. 2000;6(5):343–48. doi:10.1177/135245850000600509Google Scholar

Geraldes, R, Ciccarelli, O, Barkhof, F, et al. The current role of MRI in differentiating multiple sclerosis from its imaging mimics. Nat Rev Neurol. 2018;14(4):199–213. doi:10.1038/nrneurol.2018.14CrossRef Google Scholar PubMed

Sati, P, Oh, J, Todd Constable, R, et al. The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative. Nat Rev Neurol. 2016;12(12):714–22. doi:10.1038/nrneurol.2016.166Google Scholar

Kearney, H, Miller, DH, Ciccarelli, O. Spinal cord MRI in multiple sclerosis: diagnostic, prognostic and clinical value. Nat Rev Neurol. 2015;11(6):327–38. doi:10.1038/nrneurol.2015.80Google Scholar

Baloh, RW. Vestibular neuritis. N Engl J Med. 2003;348(11):1027–32. doi:10.1056/NEJMcp021154Google Scholar

Kish, T. Promising multiple sclerosis agents in late-stage development. PT. 2018;43(12):750–72. www.ncbi.nlm.nih.gov/pubmed/30559588 Google Scholar

Tzelepis, GE, McCool, FD. Respiratory dysfunction in multiple sclerosis. Respir Med. 2015;109(6):671–9. doi:10.1016/j.rmed.2015.01.018CrossRef Google Scholar PubMed

Yan, Y, Li, Y, Fu, Y, et al. Autoantibody to MOG suggests two distinct clinical subtypes of NMOSD. Sci China Life Sci. 2016;59(12):1270–81. doi:10.1007/s11427-015-4997-yGoogle Scholar

Neuteboom, R, Wilbur, C, Van Pelt, D, et al. The spectrum of inflammatory acquired demyelinating syndromes in children. Semin Pediatr Neurol. 2017;24(3):189–200. doi:10.1016/j.spen.2017.08.007Google Scholar

Sands, MJ, Levitin, A. Basics of magnetic resonance imaging. Semin Vasc Surg. 2004;17(2):66–82. doi:10.1053/j.semvascsurg.2004.03.011Google Scholar

Radue, EW, Bendfeldt, K, Mueller-Lenke, N, et al. Brain atrophy: an in-vivo measure of disease activity in multiple sclerosis. Swiss Med Wkly. 2013;143:1–11. doi:10.4414/smw.2013.13887Google Scholar

Pucci, E, Branãs, P, D’Amico, R, et al. Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2007;2007(1):CD002818. doi:10.1002/14651858.CD002818.pub2Google Scholar

Barrett, CL, Mann, GE, Taylor, PN, Strike, P. A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis. Mult Scler J. 2009;15(4):493–504. doi:10.1177/1352458508101320CrossRef Google Scholar PubMed

Goodman, AD, Brown, TR, Krupp, LB, et al. Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. Lancet. 2009;373(9665):732–8. doi:10.1016/S0140-6736(09)60442-6Google Scholar

Fischer, C, Mauguière, F, Ibanez, V, et al. The acute deafness of definite multiple sclerosis: BAEP patterns. Electroencephalogr Clin Neurophysiol. 1985;61(1):7–15. doi:10.1016/0013-4694(85)91066-1Google Scholar

Gelfand, JM. Multiple Sclerosis: Diagnosis, Differential Diagnosis, and Clinical Presentation. Vol 122. Goodin, DS, ed. Amsterdam: Elsevier; 2014. doi:10.1016/B978-0-444-52001-2.00011-X.Google Scholar PubMed

Eriksson, M, Andersen, O, Runmarker, B. Long-term follow up of patients with clinically isolated syndromes, relapsing-remitting and secondary progressive multiple sclerosis. Mult Scler. 2003;9:260–74.CrossRef Google Scholar PubMed

Scalfari, A, Neuhaus, A, Daumer, M, et al. Early relapses, onset of progression, and late outcome in multiple sclerosis. JAMA Neurol. 2013;70(2):214–22. doi:10.1001/jamaneurol.2013.599Google Scholar

Olek, MJ. Differential diagnosis, clinical features, and prognosis of multiple sclerosis. Curr Clin Neurol Mult Scler. 2005:15–53.Google Scholar

Willis, MA, Fox, RJ. Progressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):785–98. doi:10.1007/978-1-4471-2395-8Google Scholar PubMed

Wingerchuk, DM, Carter, JL. Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc. 2014;89(2):225–40. doi:10.1016/j.mayocp.2013.11.002Google Scholar

Nyquist, PA, Cascino, GD, Rodriguez, M. Seizures in patients with multiple sclerosis seen at Mayo Clinic, Rochester, Minn, 1990–1998. Mayo Clin Proc. 2001;76(10):983-986. doi:10.4065/76.10.983Google Scholar

Sarioglu, B, Serdaroglu, G, Tutuncuoglu, S, Ozer, EA. The use of botulinum toxin type A treatment in children with spasticity. Pediatr Neurol. 2003;29(4):299–301. doi:10.1016/S0887-8994(03)00269-8Google Scholar

Feinstein, A, Freeman, J, Lo, AC. Treatment of progressive multiple sclerosis: what works, what does not, and what is needed. Lancet Neurol. 2015;14(2):194–207.Google Scholar

Coyle, PK. Symptom management and lifestyle modifications in multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):815–36. doi:10.1212/CON.0000000000000325Google Scholar

Tornes, L, Conway, B, Sheremata, W. Multiple sclerosis and the cerebellum. Neurol Clin. 2014;32:957–77.Google Scholar

Ingram, G, Hirst, CL, Robertson, NP. What is the risk of permanent disability from a multiple sclerosis relapse? Neurology. 2010;75(9):837.CrossRef Google Scholar PubMed

Ching, B, Mohamed, A, Khoo, T, Ismail, H. Multiphasic disseminated encephalomyelitis followed by optic neuritis in a child with gluten sensitivity. Mult Scler J. 2015;21(9):1209–11. doi:10.1177/Google Scholar

Freedman, MS, Rush, CA. Severe, highly active, or aggressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):761–84. doi:10.1212/CON.0000000000000331Google Scholar

Accessibility standard: Unknown

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future.