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Summary
Multiple sclerosis is a complex disease associated with a wide variety of different
symptoms that can affect the ability of multiple sclerosis patients to carry out normal
activities of daily living. Although a myriad of symptoms can afflict these patients,
the most commonly reported include fatigue, mood disorders, changes in cognitive function
or memory, sensory changes (numbness, pain, vibrations), motor changes (loss of balance,
poor coordination, muscle weakness or stiffness), vision changes (double vision, blurred
vision, loss of vision) and bladder or bowel dysfunction. Treatments are available
that can help minimise some of these symptoms and relieve patient distress. After
the diagnosis has been established and a decision taken regarding initiation of immunomodulatory
treatments, the majority of management decisions with which the physician will be
confronted will concern symptom management. Whereas some symptoms are relatively easily
treated, others are more difficult to manage. Management involves rehabilitation,
pharmacological treatments and surgical procedures. Successful symptom management
is a key determinant of quality of life for the patient and is the basis for improving
physical and psychological function.
Keywords
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References
- Doctors and patients don't agree: cross sectional study of patients' and doctors' perceptions and assessments of disability in multiple sclerosis.BMJ. 1997; 314: 1580-1583
- The effect of disease, functional status, and relapses on the utility of people with multiple sclerosis in the UK.Value Health. 2007; 10: 54-60
- Living with multiple sclerosis: longitudinal changes in employment and the importance of symptom management.J Neurol. 2010; 257: 926-936
- Quality of life in multiple sclerosis: the impact of depression, fatigue and disability.Mult Scler. 2001; 7: 340-344
- Quality of life in patients with multiple sclerosis: the impact of fatigue and depression.J Neurol Sci. 2002; 205: 51-58
- Depression is the main determinant of quality of life in multiple sclerosis: a classification-regression (CART) study.Disabil Rehabil. 2006; 28: 307-314
- Depression and quality of life in multiple sclerosis.Acta Neurol Scand. 2001; 104: 257-261
- Neurological disability, psychological distress, and health-related quality of life in MS patients within the first three years after diagnosis.Mult Scler. 2009; 15: 752-758
- A multimodal approach to managing the symptoms of multiple sclerosis.Neurology. 2004; 63: S12-S18
- Major depression in multiple sclerosis: a population-based perspective.Neurology. 2003; 61: 1524-1527
- Depression and multiple sclerosis.Neurology. 1996; 46: 628-632
- Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample.Am J Psychiatry. 2002; 159: 1862-1868
- Multiple sclerosis beyond EDSS: depression and fatigue.J Neurol Sci. 2009; 277: S37-S41
- Treatment of fatigue in multiple sclerosis: a systematic review of the literature.Int J Nurs Pract. 2008; 14: 81-93
- Multiple sclerosis registry in Germany: results of the extension phase 2005/2006.Dtsch Arztebl Int. 2008; 105: 113-119
- Identification, causation, alleviation, and prevention of complications (ICAP): an approach to symptom and disability management in multiple sclerosis.Neurology. 2008; 71: S14-S20
- The MS Symptom and Impact Diary (MSSID): psychometric evaluation of a new instrument to measure the day to day impact of multiple sclerosis.J Neurol Neurosurg Psychiatry. 2004; 75: 577-582
- The MS Symptom and Impact Diary (MSSID): psychometric evaluation of a new instrument to measure the day to day impact of multiple sclerosis.J Neurol Neurosurg Psychiatry. 2004; 75: 526-527
- Development and first evaluation of the new patient management and documentation system MSDS 3D for patients with multiple sclerosis.Neurology. 2010; 74: A554
- Comparative assessment of Yale Single Question and Beck Depression Inventory Scale in screening for depression in multiple sclerosis.Mult Scler. 2003; 9: 307-310
- One question as a screening instrument for depression in people with multiple sclerosis.Clin Rehabil. 2007; 21: 460-464
- Sexual dysfunction in multiple sclerosis: a case–control study. I. Frequency and comparison of groups.Mult Scler. 1999; 5: 418-427
- Sexual dysfunction in multiple sclerosis: a 2-year follow-up study.J Neurol Sci. 2001; 187: 1-5
- Immunologically mediated fatigue: a murine model.Clin Immunol Immunopathol. 1992; 64: 161-165
- Brain-immune communication psychoneuroimmunology of multiple sclerosis.Mult Scler. 2008; 14: 6-21
- Endocrine and cytokine responses to acute psychological stress in multiple sclerosis.Brain Behav Immun. 2002; 16: 282-287
- Chronic fatigue syndrome – aetiological aspects.Eur J Clin Invest. 1997; 27: 257-267
- Fatigue in multiple sclerosis compared with chronic fatigue syndrome: A quantitative assessment.Neurology. 1996; 46: 632-635
- Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue: a 18F-fluorodeoxyglucose positron emission tomography study.Neurology. 1997; 48: 1566-1571
- Demyelinating, inflammatory and degenerative diseases.Curr Opin Neurol Neurosurg. 1990; 3: 881-883
- Postexercise phosphocreatine resynthesis is slowed in multiple sclerosis.Muscle Nerve. 1994; 17: 835-841
- The effect of immunomodulatory treatment on multiple sclerosis fatigue.J Neurol Neurosurg Psychiatry. 2004; 75: 1045-1047
- Effects of glatiramer acetate on fatigue and days of absence from work in first-time treated relapsing–remitting multiple sclerosis.Health Qual Life Outcomes. 2008; 6: 67
- Symptomatic treatment of multiple sclerosis. Multiple Sclerosis Therapy Consensus Group (MSTCG) of the German Multiple Sclerosis Society.Eur Neurol. 2006; 56: 78-105
- Treatment of depression improves adherence to interferon beta-1b therapy for multiple sclerosis.Arch Neurol. 1997; 54: 531-533
- Treatment of depression for patients with multiple sclerosis in neurology clinics.Mult Scler. 2006; 12: 204-208
- Meta-analysis of the efficacy and safety of Sativex (nabiximols), on spasticity in people with multiple sclerosis.Mult Scler. 2010; 16: 707-714
- Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial.Lancet. 2009; 373: 732-738
- Rehabilitation and multiple sclerosis: hot topics in the preservation of physical functioning.J Neurol Sci. 2011; 311: S43-S47
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© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
