Symptomatic Therapies in Multiple Sclerosis | Part I

Key takeaways

• Symptomatic management is an essential component of Multiple Sclerosis (MS) care, addressing spasticity, ataxia, mobility impairment, tremor, sensory disturbances, and pain to improve daily functioning and quality of life.
• Spasticity affects approximately 60% of people with MS and can significantly impair mobility, sleep, and overall quality of life.
• Spasticity management requires a combination of pharmacological and non-pharmacological approaches, including rehabilitation, stretching, oral antispastic agents, nabiximols, botulinum toxin injections, and intrathecal baclofen in selected cases.
• Ataxia and tremor are frequent and disabling manifestations of MS, often associated with cerebellar dysfunction. Their assessment and management remain challenging, highlighting the importance of targeted clinical evaluation and individualized therapeutic strategies.
• Mobility impairment requires targeted symptomatic interventions. Evidence indicates that prolonged-release fampridine can improve walking speed in approximately one-third of patients with ambulatory impairment, although potential adverse effects and contraindications must be considered.
• Neuropathic pain and sensory disturbances substantially affect quality of life in MS. Management requires assessment of pain mechanisms and may involve anticonvulsants, antidepressants, rehabilitation, psychological interventions, and selected neuromodulation techniques.
• Trigeminal neuralgia requires specific therapeutic considerations, with carbamazepine or oxcarbazepine among the principal pharmacological options.

The presentation

The experts biographies

Veronica Popescu

Neurologist specialized in Multiple Sclerosis at the University MS Center Pelt -Hasselt, Noorderhart Hospital and Hasselt University

Carlo Pozzilli

Professor of Clinical Neuroscience at University of Rome “La Sapienza”

Bart Van Wijmeersch

Associate Professor of Neurology at the University of Hasselt

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