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Multiple sclerosis: Symptomatic treatment

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Abstract

Reports of new therapeutic agents designed to suppress inflammatory processes in multiple sclerosis have excited much interest but, thus far, have had little influence on symptoms, disability and handicap in patients. The clinical application of recent advances in physical, pharmacological and surgical approaches to management will, at least in the medium-term future, therefore offer significantly greater opportunities for improving the quality of life of patients with multiple sclerosis. Here, symptomatic treatment of the whole range of difficulties encountered by patients with multiple sclerosis is reviewed in the context of the multidisciplinary strategy crucial to an optimal outcome.

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References

  1. Aisen ML, Arnold A, Baiges I, Maxwell S, Rosen M (1993) The effect of mechanical damping loads on disabling action tremor. Neurology 43:1346–1350

    Google Scholar 

  2. Averbuch-Heller L, Stahl JS, Rottach KG, Leigh RJ (1995) Gabapentin as treatment of nystagmus. Ann Neurol 38:972

    Google Scholar 

  3. Barren FM (1984) Sexual implications of multiple sclerosis. In: Simons AF (ed) Multiple sclerosis: psychological and social aspects. Heineman, London, pp 54–71

    Google Scholar 

  4. Benkelman DR, Kraft GH, Freal J (1985) Expressive communicative disorders in persons with multiple sclerosis. Arch Phys Med Rehabil 66:675–679

    Google Scholar 

  5. Betts CD, D'Mellow MT, Fowler CJ (1993) Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerois. J Neurol Neurosurg Psychiatry 56:245–250

    Google Scholar 

  6. Betts CD, Jones SJ, Fowler CG, Fowler CJ (1994) Erectile dysfunction in multiple sclerosis: associated neurological and neurophysical deficits, and treatment of the condition. Brain 117:1303–1310

    Google Scholar 

  7. Bever CT, Young D, Tierney D, Conway K, Katz E, Costello K, Fossler M, Johnson KP (1995) The pharmacokinetics and tolerability of a slow-release formulation of 4-aminopyridine in multiple sclerosis patients. Neurology 45 [Suppl 4]:684P

  8. Brown P (1994) Pathophysiology of spasticity. J Neurol Neurosurg Psychiatry 57:773–777

    Google Scholar 

  9. Chia Y-W, Fowler CJ, Kamm MA, Henry MM, Lemieux M-C, Swash M (1995) Prevalence of bowel dysfunction in patients with multiple sclerosis and bladder dysfunction. J Neurol 242:105–108

    Google Scholar 

  10. Coyle PK, Krupp LB, Doscher C, Deng Z, Milazzo A (1995) Clinical and immunological effects of cooling in multiple sclerosis. Ann Neurol 38:312

    Google Scholar 

  11. Darley FL, Brown JR, Goldstein NP (1972) Dysarthria in multiple sclerosis. J Speech Hear Res 15:229–233

    Google Scholar 

  12. Davis FA, Stefoski D, Rush J (1990) Orally administered 4-aminopyridine improves clinical signs in multiple sclerosis. Ann Neurol 27:186–192

    Google Scholar 

  13. Eckford SD, Carter PG, Jackson SR, et al (1995) An open in-patient incremental safety and efficacy study of desmopressin in women with multiple sclerosis and nocturia. Br J Urol 74:459–463

    Google Scholar 

  14. Edwards (1996) Neurological physiotherapy. Churchill Livingstone, pp 63–68

  15. Feinstein A, du Boulay G, Ron M (1992) Psychotic illness in multiple sclerosis: a clinical and MRI study. Br J Psychiatry 161:680–685

    Google Scholar 

  16. Filippi M, Watts P, Eaton L, Homer JC, McDonald WI, Thompson AJ (1996) Mark VII microclimate system [cooling suit] in the symptomatic treatment of multiple sclerosis patients with marked temperature sensitivity: a preliminary study. Argomenti Neurol 5:162–165

    Google Scholar 

  17. Fowler CJ (1996) Investigation of the neurological bladder. J Neurol Neurosurg Psychiatry 60:6–13

    Google Scholar 

  18. Fowler CJ, Beck RO, Gerrard S, Betts CD, Fowler CG (1994) Intravesical capsaicin for treatment of detrusor hyperreflexia. J Neurol Neurosurg Psychiatry 57:169–173

    Google Scholar 

  19. Haller M, Lindsey JW, Adelsrein BD, Riley PO (1985) Controlled trial of isoniazid therapy for severe postural cellebellar tremor in multiple sclerosis. Neurology 35:1374–1377

    Google Scholar 

  20. Hinds JP, Eidelman BH, Wald A (1990) Prevalence of bowel dysfunction in multiple sclerosis: a population survey. Gastroenterology 98:1538–1542

    Google Scholar 

  21. Hobart JC, Lamping DL, Thompson AJ (1996) Evaluation neurological outcome measures: the bare essentials. J Neurol Neurosurg Psychiatry 60:127–130

    Google Scholar 

  22. Hughes JC, Enderby PM, Langton-HewerR (1994) Dysphagia and multiple sclerosis: a study and discussion of its nature and impact. Clin Rehabil 8:18–26

    Google Scholar 

  23. Khan OA, Olek MJ (1995) Treatment of paroxysmal symptoms in multiple sclerosis with bromocriptine. J Neurol Neurosurg Psychiatry 58:253

    Google Scholar 

  24. Kidd D, Howard RS, Losseff NA, Thompson AJ (1995) The benefit of unpatient neurorehabilitation in multiple sclerosis. Clin Rehabilitation 9:198–203

    Google Scholar 

  25. Krupp LB, Alvarez LA, La Rocca NG, Scheinberg LC (1988) Fatigue in multiple sclerosis. Arch Neurol 45:435–437

    Google Scholar 

  26. Krupp LB, Coyle PK, Doscher C, Miller AE, Cross AH, Jandorf L, Halper J, Johnson B, Morgante L, Grimson R (1995) Fatigue therapy in multiple sclerosis: results of a double-blind, randomised, parallel trial of amantadine, pemoline and placebo. Neurology 45:1956–1961

    Google Scholar 

  27. Lee J, Elston J, Vickers S, et al (1988) Botulinum toxin therapy for squint. Eye 2:24–28

    Google Scholar 

  28. Matthews WB (1958) Tonic seizures in disseminated sclerosis. Brain 81:193–206

    Google Scholar 

  29. Matthews WB (1991) Clinical aspects. In: Matthews WB (ed) McAlpine's multiple sclerosis, 2nd edn. Churchill Livingstone, Edingburgh, pp 43–105

    Google Scholar 

  30. Mattson D, Petrie M, Stivastava DK, McDermott M (1995) Multiple sclerosis: sexual dysfunction and ats response to medications. Arch Neurol 52:862–868

    Google Scholar 

  31. McLean BN (1993) Intrathecal baclofen in severe spasticity. Br J Hosp Med 49:262–267

    Google Scholar 

  32. Minderhoud JM, Leemhuis JG, Kremer J, Labane E, Smits PML (1994) Sexual disturbances arising from multiple sclerosis. Acta Neurol Scand 70:299–306

    Google Scholar 

  33. Moulin DE, Foley KM, Ebers GC (1988) Pain syndromes in multiple sclerosis. Neurology 38:1830–1834

    Google Scholar 

  34. Nathan PW (1959) Intrathecal phenol to relieve spasticity in paraplegia. Lancet II:1099–1102

    Google Scholar 

  35. Nguyen JP, Degos JD (1993) Thalamic stimulation and proximal tremor: a specific target in the nucleus ventrointermedius thalami. Arch Neurol 47:596–599

    Google Scholar 

  36. Nguyen JP, Pollin B, Feve A, Geny C, Ricolfi F, Niclot P, Degos J-D, Cesaro P (1995) Treatment of severe tremor by chronic thalamic stimulation in 25 patients with multiple sclerosis. J Neuroimmunol [Suppl] 1:30

    Google Scholar 

  37. Ochs G, Struppler A, Meyerson BA, Linderoth B, Gybels J, Gardner BP, Teddy P, Jamous A, Weinmann P (1989) Intrathecal baclofen for long term treatment of spasticity: a multicentre study. J Neurol Neurosurg Psychiatry 52:933–939

    Google Scholar 

  38. Penn RD, Savoy SM, Corcos D, Latash M, Gottlieb G, Parke B, Kroin JS (1989) Intrathecal baclofen for severe spinal spasticity. N Engl J Med 320:1517–1521

    Google Scholar 

  39. Polman CH, Bertelsmann FW, Loenen AC van, Koetsier JC (1994) 4-Aminopyridine in the treatment of patients with MS. Long term efficacy and safety. Arch Neurol 51:292–296

    Google Scholar 

  40. Rao SM, Leo GJ, Bernardin L, Unverzagt F (1991) Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology 41:685–691

    Google Scholar 

  41. Rao SM, Leo GJ, Bernardin L, Unverzagt F (1991) Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology 41:692–696

    Google Scholar 

  42. Reder AT, Amason BGW (1994) Trigeminal neuralgia in multiple sclerosis relieved by a prostoglandin E analogue. Neurology 45:1097–1100

    Google Scholar 

  43. Rice G, Dickey C, Lesaux J, Vandervoort P, MacEwan L, Ebers G (1995) Ondansetron for disabling cerebellar tremor. Ann Neurol 38:973

    Google Scholar 

  44. Ron M, Feinstein A (1992) Multiple sclerosis and the mind (editorial) J Neurol Neurosurg Psychiatry 55:1–3

    Google Scholar 

  45. Ron MA, Logsdail SJ (1989) Psychiatric morbidity in multiple sclerosis: a clinical and MRI study. Psychol Med 19:887–895

    Google Scholar 

  46. Shellenberger MK, Wallace JD, and the US Tizanidine Study Group (1995) Extended efficacy of tizanadine in treatment of spasticity in patients with multiple sclerosis (MS) Neurology [Suppl] 4:683P

  47. Sherratt RM, Bostock H, Sears TA (1980) Effects of 4-aminopyridine on normal and demyelinated mammalian nerve fibres. Nature 283:570–572

    Google Scholar 

  48. Skeil DA, Barnes MP (1994) The local treatment of spasticity. Clin Rehabil 8:240–246

    Google Scholar 

  49. Smith C, Birnbaum G, Carter JL, Greenstein J, Lublin FD and the US Tizanidine Study Group (1994) Tizanidine treatment of spasticity caused by multiple sclerosis: results of a doubleblind, palcebo controlled trial. Neurology 44:S34-S43

    Google Scholar 

  50. Snow BJ, Tsui JKC, Bhatt MH, Varelas M, Hashimoto SA, Calne DB (1990) Treatment of spasticity with botulinum toxin: a double-blind study. Ann Neurol 28:512–515

    Google Scholar 

  51. Speelman JD, Manen J van (1984) Stereotactic thalamotomy for the relief of intention tremor in multiple sclerosis. J Neurol Neurosurg Psychiatry 47:596–599

    Google Scholar 

  52. Stenager E, Knudsen L, Jensen K (1991) Acute and chronic pain syndromes in multiple sclerosis. Acta Neurol Scand 84:197–200

    Google Scholar 

  53. The United Kingdom Tizanidine Trial Group (1995) A double-blind, placebo-controlled trial of tizanadine in the treatment of spasticity caused by multiple sclerosis. Neurology 44:S70-S78

    Google Scholar 

  54. Thompson AJ (1995) Neurorehabilitation for people with multiple sclerosis. In: Proceedings of the MS Forum: psychosocial factors in multiple sclerosis. Modern Management Workshop, Rome, April 1995, pp 9–12

  55. Thompson AJ, Kermode AG, Moseley IF, MacManus DG, McDonald WI (1993) Seizures due to multiple sclerosis: seven patients with MRI correlations. J Neurol Neurosurg Psychiatry 56:1317–1320

    Google Scholar 

  56. Traccis S, Rosati G, Monaco MF, Aiello I, Agnetti V (1990) Successful treatment of acquired pendular elliptical nystagmus in multiple sclerosis with isoniazid and base-out prisms. Neurology 40:492–494

    Google Scholar 

  57. 57.Truyen L, Barkhof F, Frequin STFM, Polman CH, Tobi H (1996) Magnetic resonance imaging of epilepsy in multiple sclerosis: a case control study. Implications for treatment trials with 4-aminopyridine. Multiple Sclerosis 4:213–217

    Google Scholar 

  58. Valleroy MI, Kraft GH (1984) Sexual dysfunction in multiple sclerosis. Arch Phys Med Rehabil 65:125–129

    Google Scholar 

  59. Vandeman HAM, Polman CH, Dongen TMMM van, Loenen AC van, Nauta JJP, Taphoorn MJB, Walbeek HK van, Koetsier JC (1992) The effect of 4-aminopyridine on the clinical signs in MS: a randomised, placebo controlled, double blind cross over study. Ann Neurol 32:123–130

    Google Scholar 

  60. Vermote R, Ketelaer P, Carton H (1986) Pain in multiple sclerosis patients. Clin Neurol Neurosurg 88:87–93

    Google Scholar 

  61. Watson CW (1959) Effects of lowering body temperature on the symptoms and signs of multiple sclerosis. N Engl J Med 261:1253–1259

    Google Scholar 

  62. Weinshenker BG, Penman M, Bass B, Ebers GC, Rice GPA (1992) A double-blind, randomized, crossover trial of pemoline in fatigue associated with multiple sclerosis. Neurology 42:1468–1471

    Google Scholar 

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Thompson, A.J. Multiple sclerosis: Symptomatic treatment. J Neurol 243, 559–565 (1996). https://doi.org/10.1007/BF00900942

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