Symptom management of multiple sclerosis in adults
- Michael J Olek, DO
Michael J Olek, DO
- Associate Professor of Neurology
- Loma Linda University Medical Center
- Ram N Narayan, MD
Ram N Narayan, MD
- Neuroimmunology and Neuroinfectious Disease Fellow
- University of Texas Southwestern Medical Center
- Johns Hopkins School of Medicine
- National Institutes of Health
- Elliot M Frohman, MD, PhD
Elliot M Frohman, MD, PhD
- Professor of Neurology
- Director of the MS and Neuroimmunology Center
- University of Texas at Austin Dell Medical School
- Teresa C Frohman, PA-C
Teresa C Frohman, PA-C
- Associate Professor of Neurology
- Managing Director of the MS and Neuroimmunology Center
- University of Texas at Austin Dell Medical School
Multiple sclerosis (MS) is an immune-mediated, inflammatory, neurodegenerative disease of the central nervous system that is a leading cause of disability in young adults.
A range of symptomatic problems can occur in patients with MS. Cognitive dysfunction, depression, fatigue, and gait impairment are increasingly common with disease progression. Spasticity, tremor, seizures, sphincter dysfunction, and sexual dysfunction may also complicate disease progression.
Management of the comorbid problems associated with MS will be reviewed here. Other aspects of MS management are discussed separately. (See "Treatment of acute exacerbations of multiple sclerosis in adults" and "Disease-modifying treatment of relapsing-remitting multiple sclerosis in adults" and "Treatment of progressive multiple sclerosis in adults".)
Common symptoms of bladder dysfunction in patients with MS include urinary frequency, urgency, and nocturia. Urinary tract infections are also common in MS, particularly in women, and may increase the extent of bladder dysfunction . (See "Clinical features of multiple sclerosis in adults", section on 'Bowel and bladder dysfunction'.)
Our approach in evaluating a patient with urinary symptoms involves the following steps:
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- BLADDER DYSFUNCTION
- BOWEL DYSFUNCTION
- COGNITIVE IMPAIRMENT
- Pharmacologic treatment
- Nonpharmacologic approaches
- GAIT IMPAIRMENT
- HEAT INTOLERANCE
- PAROXYSMAL SYMPTOMS
- SEXUAL DYSFUNCTION
- SPEECH, SWALLOW, AND RESPIRATORY FUNCTION
- VISUAL SYSTEM DISTURBANCES
- VITAMIN D
- COMPLEMENTARY AND ALTERNATIVE MEDICINE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS