This clinical article reflects a selected review of many of the symptoms commonly experienced as complications of multiple sclerosis. Neurologists generally are not trained to treat many of the simple medical problems discussed in this review, but they are often asked to handle these conditions by their patients with multiple sclerosis. Medications approved in the last year for symptomatic treatment of pseudobulbar affect are highlighted. The realistic clinical vignette provides practical, easy-to-apply lessons in patient management. Off-label uses of therapy are discussed. Costs of many of the therapies used for symptomatic treatment are listed. References used in this review and in prior updates have been cited selectively.