Multiple sclerosis: treatment of its symptoms

Introduction
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By Jill Conway MD and Michael Kaufman MD

In this clinical summary, Regina Berkovich MD PhD of the USC Keck School of Medicine and St-Petersburg Pavlov State Medical University and Daniel Kantor MD of Neurologique Foundation discuss treatment of the most common symptoms experienced by patients with multiple sclerosis. It is incumbent upon neurologists, as the primary professionals involved in multiple sclerosis patient care, to become well adept at managing the symptoms important to patients and their care partners/caregivers. Although there is increased attention on new disease-modifying agents, patients need therapeutic plans that improve their daily quality of life and enhance functioning (through neurofunctional enhancers). Advances in ongoing clinical trials for multiple sclerosis–related spasticity and pain are highlighted. The realistic clinical vignette provides practical, easy-to-apply lessons in patient management. Off-label uses of therapy are discussed. References used in this review and in prior updates have been cited selectively.

Key Points

  • Multiple sclerosis patients present with a wide variety of differing symptoms.
  • The goal of individualized medicine is to treat each unique person in an individual way; this includes addressing symptoms affecting their quality of life.
  • The goal of symptomatic therapy is to optimize the functioning of patients with neurologic dysfunction due to multiple sclerosis; a subset of these treatments may act as neurofunctional enhancers.
  • There are a wide variety of pharmacologic and non-pharmacologic therapies that may benefit individual patients.
  • It is incumbent upon neurologists to hone their skills in symptom management.

In This Article

Introduction
Historical note and nomenclature
Scientific basis
Indications
Contraindications
Goals and endpoint
Description
Outcome
Adverse effects
Prognosis
Clinical vignette
Pregnancy
References cited
Contributors