Symptomatic Therapy in Multiple Sclerosis

The ability to recognize and manage the multitude of symptoms with which multiple sclerosis (MS) patients are faced can have a significant and beneficial impact on their quality of life. MS is the most common disabling neurologic disease of young adults. MS is a complex disease and patients can experience a wide variety of symptoms that can affect their ability to carry out normal activities of daily living (ADLs). This chapter discusses the most common issues that MS patients face and recommendations are given for the evaluation and management for each. The information presented should serve as a useful reference for clinicians in their care of patients and families who live with MS. Symptomatic therapy discussed are (1) neuro-ophthalmalogy, (2) vestibular dysfunction, (3) neurogenic bowel, (4) neurogenic bladder, (5) sexual dysfunction, (6) fatigue, (7) heat intolerance, (8) pain, and (9) spasticity. The afferent and efferent neuro-ophthalmologic hallmarks of MS and their associated symptoms are described. Various therapeutic interventions used to mitigate what often are perceived by patients as highly stress-provoking and often disabling visual and vestibular concomitants of the MS disease process are underscored.