Multidisciplinary Management of Multiple Sclerosis Symptoms

Abstract

Background: Effective management of multisymptomatic chronic diseases such as multiple sclerosis (MS) requires a multimodal, interdisciplinary approach. At MS clinics, numerous healthcare specialties are coordinated to provide patients with quality clinical care for all aspects of their disease. Settings and resource availability may vary between countries. Four specific specialty services from different EU countries are examined in more detail. Summary: The multidisciplinary neurorehabilitation team in Rennes, France, provides specialized consultations (e.g. spasticity, urodynamic unit, devices), inpatient and outpatient intensive rehabilitation programs and therapeutic education. Management approaches are based on a patient's level of impairment as assessed by the Expanded Disability Status Scale. In Girona, Spain, neuropsychologists perform assessments as part of the neurological protocol for all patients with MS. Depending on the level of impairment and patients' characteristics (e.g. working or not working), cognitive deficits may be treated at home or at a neurorehabilitation center. In Barcelona, Spain, neuro-ophthalmologists are involved in the differential diagnosis and follow-up care of MS patients with visual disturbances; particular attention is given to patients' vision-related quality of life. Pain specialists at the Marianne Strauß Klinik in Berg, Germany, have developed a system for classifying MS pain syndromes and differentiating MS-related pain from non MS-related pain. Chronic pain management involves numerous disciplines and requires active engagement by patients in developing treatment plans. Key Messages: MS affects several body systems and patients invariably require specialized interdisciplinary support. Insight into services provided by various specialties and their fit within multidisciplinary care models at MS centers may facilitate the design or refinement of care models in other locations.

Living with multiple sclerosis: A Jordanian perspective

“…The different symptoms such as physical, visual, cognitive, and psychological required them to visit many physicians in different places. Consistent with our findings, a recent study by Gallien, Gich, Sanchez‐Dalmau, and Feneberg () recommended that patients with MS require a specialized interdisciplinary support (Gallien et al, ). Services provided by various specialties that fit within multidisciplinary care models at MS centres may facilitate the design and enhance the care for them (Gallien et al, ).…”

“…Consistent with our findings, a recent study by Gallien, Gich, Sanchez‐Dalmau, and Feneberg () recommended that patients with MS require a specialized interdisciplinary support (Gallien et al, ). Services provided by various specialties that fit within multidisciplinary care models at MS centres may facilitate the design and enhance the care for them (Gallien et al, ). This study indicates that there is a clear need of enhancing the capacity of the governmental hospitals by increasing the number of the treating neurologists and the specialized MS centres, especially the ones that provides rehabilitation services.…”

Multidisciplinary Management of Sexual Dysfunction, Perineal Pain, and Elimination Dysfunction in a Woman with Multiple Sclerosis

“…Multiple symptoms require a multimodal approach, according to the literature. 14,15 In the past few decades, research has addressed how these symptoms affect the quality of life of patients with MS; however, few studies assess the management of SD in women. Sexual dysfunction is a prevalent and destructive manifestation of the disease that severely affects quality of life.…”

Neurorehabilitation in Multiple Sclerosis – Resilience in Practice

“…[86][87][88][89][90] This team should involve a neurologist trained in rehabilitation medicine, and multiple other therapists including speech therapists, psychologists, MS nurses, orthopaedic technicians, physiotherapists, ergotherapists and social service representatives (see Figure 2). All should interact and operate in a coordinated way and work to an integrated clinical care pathway.…”