ABSTRACT
PURPOSE OF REVIEW: This review focuses on recent advances in the understanding and management of symptoms and dysfunctions associated with multiple sclerosis (MS). RECENT FINDINGS: A broad spectrum of dysfunctions associated with MS are under investigation. Research published in the past year and a half addresses gait dysfunction, exercise training, fatigue, bowel/bladder and sexual dysfunction, and sleep disruption. Functional electrical stimulation and strength training have been validated for improvement in gait and motor function. Exercise training has been shown to benefit mood and quality of life scores and to reduce circulating inflammatory cytokine levels. Fatigue remains a challenging problem with incremental improvements in understanding of underlying causes and effective drug therapies offered by recent work. Treatment of bowel, bladder and sexual dysfunction utilizing a variety of modalities has been investigated with some progress. SUMMARY: In the absence of treatments to reverse neurologic injury due to MS, effective symptom management and functional improvement remain essential to mitigate disability and maintain quality of life. Basic research, as well as controlled clinical trials, in this realm offers promising insights and solutions.
Subject(s)
Multiple Sclerosis/physiopathology , Multiple Sclerosis/therapy , Electric Stimulation Therapy , Exercise Therapy , Fatigue/etiology , Fatigue/therapy , Humans , Multiple Sclerosis/complications , Multiple Sclerosis/pathology , Neural Conduction/physiology , Neuropsychological Tests , Sleep/physiology , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapyABSTRACT
Multiple sclerosis is the most common disabling neurologic disease affecting young adults and adolescents in the United States. The first objective of this article is to familiarize nonspecialists with the cardinal features of multiple sclerosis and our current understanding of its etiology, epidemiology, and natural history. The second objective is to explain the approach to diagnosis. The third is to clarify current evidence-based treatment strategies and their roles in disease modification. The overall goal is to facilitate the timely evaluation and confirmation of diagnosis and enhance effective management through collaboration among primary physicians, neurologists, and other care providers who are confronted with these formidably challenging patients.
