Dr Aliza Ben-Zacharia provides an overview of the importance of symptom management in multiple sclerosis, common multiple sclerosis symptoms and their impact, challenges in symptom management and how shared decision-making can help optimize symptom management.1/2 Next Interview
Dr Barry Singer outlines how symptom management differs from disease modification in multiple sclerosis care, provides examples of treatments for managing multiple sclerosis symptoms, and describes the future of symptom management in multiple sclerosis.2/2 Leave Feedback
Learning Objectives & Overview
Despite advances in disease modifying treatments, persons with multiple sclerosis (MS) experience a variety of often progressive and disabling symptoms, which impact many aspects of daily living, social relationships, jobs and health-related quality of life (HRQoL)1-12 Symptomatic treatments are used for the amelioration of MS symptoms affecting functional abilities and HRQoL.2
Watch two leading experts discuss the importance of managing symptoms in multiple sclerosis,13-16 the impact of symptoms,1-12 how to optimize symptom management and challenges17-27 and the evidence for various treatment strategies.28-41
After watching this activity you should be able to:
- Discuss the importance of symptom management in MS care.
- Explain how shared decision making can be used to optimize the management of MS symptoms.
- Analyze evidence for the management of MS symptoms
- Buzaid A, Dodge MP, Handmacher L, et al. Activities of daily living: evaluation and treatment in persons with multiple sclerosis. Phys Med Rehabil Clin N Am 2013; 24(4): 629-38.
- Filippi M, Bar-Or A, Piehl F, et al. Multiple sclerosis. Nat Rev Dis Primers 2018; 4(1): 43.
- Gil-González I, Martín-Rodríguez A, Conrad R, et al. Quality of life in adults with multiple sclerosis: a systematic review. BMJ Open 2020; 10(11): e041249.
- Hakim EA, Bakheit AM, Bryant TN, et al. The social impact of multiple sclerosis--a study of 305 patients and their relatives. Disabil Rehabil 2000; 22(6): 288-93.
- Raggi A, Covelli V, Schiavolin S, et al. Work-related problems in multiple sclerosis: a literature review on its associates and determinants. Disabil Rehabil 2016; 38(10): 936-44.
- Brass SD, Duquette P, Proulx-Therrien J, et al. Sleep disorders in patients with multiple sclerosis. Sleep Med Rev 2010; 14(2): 121-9.
- Ehde DM, Gibbons LE, Chwastiak L, et al. Chronic pain in a large community sample of persons with multiple sclerosis. Mult Scler 2003; 9(6): 605-11.
- Janardhan V, Bakshi R. Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 2002; 205(1): 51-8.
- Krupp L. Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Mult Scler 2006; 12(4): 367-8.
- Rizzo MA, Hadjimichael OC, Preiningerova J, et al. Prevalence and treatment of spasticity reported by multiple sclerosis patients. Mult Scler 2004; 10(5): 589-95.
- Sammarco A. The Bladder in MS: A Review. Neurol Neurophysiol 2014; 5: 3.
- Silveira C, Guedes R, Maia D, et al. Neuropsychiatric Symptoms of Multiple Sclerosis: State of the Art. Psychiatry Investig 2019; 16(12): 877-88.
- Baird JF, Sandroff BM, Motl RW. Therapies for mobility disability in persons with multiple sclerosis. Expert Rev Neurother 2018; 18(6): 493-502.
- Berger JR. Functional improvement and symptom management in multiple sclerosis: clinical efficacy of current therapies. Am J Manag Care 2011; 17 Suppl 5 Improving: S146-53.
- Conradsson D, Ytterberg C, von Koch L, et al. Changes in disability in people with multiple sclerosis: a 10-year prospective study. J Neurol 2018; 265(1): 119-26.
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- Cohen BA. Identification, causation, alleviation, and prevention of complications (ICAP): an approach to symptom and disability management in multiple sclerosis. Neurology 2008; 71(24 Suppl 3): S14-20.
- Ben-Zacharia AB. Therapeutics for multiple sclerosis symptoms. Mt Sinai J Med 2011; 78(2): 176-91.
- Armstrong MJ, Shulman LM, Vandigo J, et al. Patient engagement and shared decision-making: What do they look like in neurology practice? Neurol Clin Pract 2016; 6(2): 190-7.
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- Lorefice L, Mura G, Coni G, et al. What do multiple sclerosis patients and their caregivers perceive as unmet needs? BMC Neurol 2013; 13: 177.
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- Fernández Ó, Costa-Frossard L, Martínez-Ginés M, et al. The Broad Concept of "Spasticity-Plus Syndrome" in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms. Front Neurol 2020; 11: 152.
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- Collin C, Davies P, Mutiboko IK, et al. Randomized controlled trial of cannabis-based medicine in spasticity caused by multiple sclerosis. Eur J Neurol 2007; 14(3): 290-6.
- Cutter NC, Scott DD, Johnson JC, et al. Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. Arch Phys Med Rehabil 2000; 81(2): 164-9.
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- Nourbakhsh B, Revirajan N, Morris B, et al. Safety and efficacy of amantadine, modafinil, and methylphenidate for fatigue in multiple sclerosis: a randomised, placebo-controlled, crossover, double-blind trial. Lancet Neurol 2021; 20(1): 38-48.
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