Symptomatic Treatment of Multiple Sclerosis

Abstract

Besides immunomodulation and immunosuppression, the specific treatment of symptoms is an essential component of the overall management of multiple sclerosis (MS). Symptomatic treatment is aimed at the elimination or reduction of symptoms impairing the functional abilities and quality of life of the affected patients. Moreover, with symptomatic treatment the development of a secondary physical impairment due to an existing one may be avoided. Many therapeutic techniques as well as different drugs are used for the treatment of MS symptoms, but only a few of them have been investigated, especially in MS patients, and are approved by the national health authorities. Despite an overwhelming number of publications, only a few evidence-based studies exist and consensus reports are very rare, too. Therefore, it seemed necessary to develop a consensus statement on symptomatic treatment of MS comprising existing evidence-based literature as well as therapeutic experience of neurologists who have dealt with these problems over a long time. This consensus paper contains proposals for the treatment of the most common MS symptoms: disorders of motor function and coordination, of cranial nerve function, of autonomic, cognitive, and psychological functions as well as MS-related pain syndromes and epileptic seizures.

Validation of the Comprehensive ICF Core Set for Multiple Sclerosis from the perspective of occupational therapists

“…In addition, OTs target movement-related functions as a prerequisite for an individual when undertaking basic mobility or grabbing things (70)(71)(72)(73). The categories "b5105 Swallowing" and "b51050 Oral swallowing" were only identified by a small number of OTs.…”

“…This is probably because, in some countries, Facial Oral Tract Therapy (FOTT) is an important intervention by OTs when treating people with neurological disorders. The learning of compensatory methods, postural changes, and swallowing techniques have priority in the occupational therapy of PwMS, especially in the progression of the disease (70,74). However, in many countries teaching swallowing techniques is clearly an area for speech and language therapists (75).…”

Frequency of current utilisation of complementary and alternative medicine by patients with multiple sclerosis

“…Exercise therapy was the most frequently used CAM in our study. Some aspects might be similar to therapies used in physiotherapy, which is an important part of rehabilitation [13,22] and effective like inpatient multidisciplinary rehabilitation [15]. Under the concept of exercise therapy CAM modalities were included that were made independently by medical prescription and controlled by a neurologist or general doctor.…”

“…as an alternative or complementary therapy. CAM included all therapies, which could not be designated as established evidence based immunotherapy or symptomatic treatment of MS (conventional therapy) according to the guidelines of the Multiple Sclerosis Therapy Consensus Group (MSTCG) [13,27].…”

Unmet Needs of Patients Feeling Severely Affected by Multiple Sclerosis in Germany: A Qualitative Study

“…1 Many patients suffer from loss of multiple functions with severe physical and psychological implications leading to complex situations. 2 Even though all patients with life limiting, progressive diseases are entitled to palliative care, only very few MS patients currently receive support from specialized palliative care.…”