scholarly journals Symptomatic Therapy and Rehabilitation in Primary Progressive Multiple Sclerosis

2011 ◽  
Vol 2011 ◽  
pp. 1-22 ◽  
Author(s):  
Fary Khan ◽  
Bhasker Amatya ◽  
Lynne Turner-Stokes
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Disease Onset ◽  
Functional Independence ◽  
Symptomatic Therapy ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Relapsing Remitting

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the central nervous system and a major cause of chronic neurological disability in young adults. Primary progressive MS (PPMS) constitutes about 10% of cases, and is characterized by a steady decline in function with no acute attacks. The rate of deterioration from disease onset is more rapid than relapsing remitting and secondary progressive MS types. Multiple system involvement at onset and rapid early progression have a worse prognosis. PPMS can cause significant disability and impact on quality of life. Recent studies are biased in favour of relapsing remitting patients as treatment is now available for them and they are more likely to be seen at MS clinics. Since prognosis for PPMS is worse than other types of MS, the focus of rehabilitation is on managing disability and enhancing participation, and application of a “neuropalliative” approach as the disease progresses. This chapter presents the symptomatic treatment and rehabilitation for persons with MS, including PPMS. A multidisciplinary approach optimizes the intermediate and long-term medical, psychological and social outcomes in this population. Restoration and maintenance of functional independence and societal reintegration, and issues relating to quality of life are addressed in rehabilitation processes.

scholarly journals Quality of life in patients with multiple sclerosis and their caregivers in Colombia: One-year follow-up

Biomédica ◽  
2020 ◽  
Vol 40 (1) ◽  
pp. 129-136
Author(s):  
Elkin Beltrán ◽  
Diana Díaz ◽  
Cindy Díaz ◽  
Luis Zarco
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Chronic Fatigue ◽  
Sensory Function ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Introduction: Multiple sclerosis is a chronic inflammatory demyelinating disease associated with neurological disability. Clinical features include motor, cerebellar, visual, and sensory function alterations, as well as psychiatric comorbidities, such as depression, anxiety, and irritability. There is little literature available on the quality of life of patients and their caregivers.Objective: To assess the quality of life of patients with multiple sclerosis and their caregivers in Colombia given that there is no information on the subject in this particular population to establish comprehensive management plans.Materials and methods: We used the MusiQol and CareQol questionnaires and the Beck Depression Inventory. A prospective analytical observational protocol was designed to include patients aged 18 to 65 years with a diagnosis of relapsing-remitting multiple sclerosis between October, 2014, and October, 2015, at the Hospital Universitario San Ignacio. We evaluated quantitative variables and Spearman correlations. The data analysis was carried out with Student t and Mann-Whitney U tests.Results: A total of 55 patients with relapsing-remitting multiple sclerosis participated in the study. Chronic fatigue was the most common comorbidity in 27%. The MusiQol questionnaire revealed a good basal quality of life, which remained at similar levels in the follow-ups at six and 12 months. Quality of life was good during the study since there were no statistically significant differences between baseline and follow-up MusiQol scores. Good quality of life was also observed in caregivers.Conclusions: The quality of life of several Colombian patients diagnosed with multiple sclerosis was very good. This positive result was also observed in caregivers as evidenced by the results of the CareQol questionnaire. We also observed and indicated an inversely proportional correlation between the Expanded Disability Status Scale and the quality of life indexes.

scholarly journals Perception of stigma in patients with primary progressive multiple sclerosis

2019 ◽  
Vol 5 (2) ◽  
pp. 205521731985271
Author(s):  
Francisco Pérez-Miralles ◽  
Daniel Prefasi ◽  
Antonio García-Merino ◽  
José R Ara ◽  
Guillermo Izquierdo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Cross Sectional Study ◽  
Primary Progressive Multiple Sclerosis ◽  
Limited Information ◽  
Cross Sectional ◽  
Primary Progressive ◽  
Multiple Sclerosis Patients

Stigma associated with neurological disorders may contribute to a poor health-related quality of life. However, limited information is available in primary progressive multiple sclerosis. We investigated the presence and impact of stigma in patients with primary progressive multiple sclerosis. A non-interventional, cross-sectional study was conducted. A total of 55 primary progressive multiple sclerosis patients were studied (mean age 55.8±9.5 years, 56.4% male). The median Expanded Disability Status Scale score was 5.5 (4.0–6.5). Stigma prevalence was 78.2% ( n=43). Twenty-four patients (43.6%) were classified as depressed. Scores on the eight-item Stigma Scale for Chronic Illness correlated with physical (rho=0.464, p<0.001) and psychological (rho=0.358, p=0.007) 29-item Multiple Sclerosis Impact Scale subscores. Stigma predicted concurrent depression (odds ratio=1.13; p=0.046). Stigma was highly prevalent with a detrimental effect on quality of life and mood in primary progressive multiple sclerosis.

The pathology of primary progressive multiple sclerosis

2002 ◽  
Vol 8 (2) ◽  
pp. 93-97 ◽  
Author(s):  
W Brück ◽  
C Lucchinetti ◽  
H Lassmann
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Current Knowledge ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Secondary Progressive ◽  
Relapsing Remitting ◽  
Underlying Pathology ◽  
Clinical Subtype

The present review will focus on the current knowledge of the pathology of primary progressive multiple sclerosis lesions. Multiple sclerosis (MS) is an inflammatory demyelinating disease with a broad clinical variability. The main disease courses are relapsing-remitting, secondary progressive and primary progressive MS. Pathological studies examining the specific underlying pathology of a defined clinical subtype are rare. Here, we focus on the phatological characteristics of the MS lesions and summarize the current findings of the phatology of primary progressive MS with respect to inflammation, oligodendrocyte/myelin pathology, axon destruction and immunopathology of the lesions.

scholarly journals Quality of Life in Patients with Multiple Sclerosis

2019 ◽  
Vol 8 (3) ◽  
pp. 95-101
Author(s):  
Grażyna Franek ◽  
◽  
Marzena Bieniak ◽  
Aleksandra Cieślik ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Correlation Coefficient ◽  
Demyelinating Disease ◽  
Numerical Range ◽  
Rank Correlation ◽  
Subscale Score ◽  
Primary Progressive ◽  
Questionnaire Version

Introduction. Multiple sclerosis (MS) is an incurable demyelinating disease of the central nervous system (c.n.s.). The chronic nature of this disease causes deterioration of the physical, mental, emotional and social condition of patients, which significantly reduces their quality of life. Aim. The aim of the study was to determine the quality of life of patients with multiple sclerosis. Material and Methods. The study involved 100 patients with multiple sclerosis, associated in support groups operating in the Silesian voivodeship. Among the respondents were 77 women and 23 men. The FAMS questionnaire — version 4 (Functional Assessment of Multiple Sclerosis Quality of Life Instrument) was chosen to measure the quality of life of patients with multiple sclerosis. The obtained research material was subjected to a statistical analysis, using the statistical package STATISTICA v12 for calculations. In order to calculate the variables, the following measures were used: arithmetic mean, standard deviation, coefficient of variation, asymmetry coefficient, kurtosis coefficient, Person linear correlation coefficient, Spearman rank correlation coefficient. Results. The average results of all subscales of the FAMS questionnaire-version 4 in the examined group reached the value of 111.1 points; that is, a satisfactory level (65% of all respondents), in the absence of bad assessments, and 35% of good grades. The result is at the second level of quality of life, in the numerical range of 58–117 points. The lowest scores were recorded in the “Mobility” subscale (14.39 points), and the highest in “Other ailments” (36.77 points). Strong correlations were found between the FAMS score and individual subscales. As the subscale score increased, the FAMS score increased, and the higher the score, the better the quality of life of MS patients. The higher the respondent’s age, the lower the FAMS results, while the one-way treatment process — either pharmacology or rehabilitation — does not improve the quality of life, only integrated actions increase the quality of life of patients with MS. In the case of a form of the disease — a primary progressive and primary progressive form with exacerbations affect the quality of life of patients with MS. Conclusions. Most MS patients assessed their quality of life as satisfactory, in the absence of bad and with one-third of good scores. The existence of links between the FAMS results and all subscales indicates that the higher the subscales rated, the higher the FAMS result, i.e. the better quality of life of MS patients. Gender does not determine the quality of life of the respondents, while age, the form of the disease and the type of treatment affect the quality of life. (JNNN 2019;8(3):95–101) Key Words: multiple sclerosis, quality of life, demyelinating disease

scholarly journals Multiple Sclerosis in Malaysia: Demographics, Clinical Features, and Neuroimaging Characteristics

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
S. Viswanathan ◽  
N. Rose ◽  
A. Masita ◽  
J. S. Dhaliwal ◽  
S. D. Puvanarajah ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Demyelinating Disease ◽  
Age At Onset ◽  
Positive Family History ◽  
Disease Onset ◽  
Demyelinating Diseases ◽  
Lesion Length ◽  
Relapsing Remitting ◽  
Spectrum Disorders

Background. Multiple sclerosis (MS) is an uncommon disease in multiracial Malaysia. Diagnosing patients with idiopathic inflammatory demyelinating diseases has been greatly aided by the evolution in diagnostic criterion, the identification of new biomarkers, and improved accessibility to neuroimaging in the country.Objectives. To investigate the spectrum of multiple sclerosis in Malaysia.Methods. Retrospective analysis with longitudinal follow-up of patients referred to a single tertiary medical center with neurology services in Malaysia.Results. Out of 245 patients with idiopathic inflammatory demyelinating disease, 104 patients had multiple sclerosis. Female to male ratio was 5 : 1. Mean age at onset was 28.6 ± 9.9 years. The Malays were the predominant racial group affected followed by the Chinese, Indians, and other indigenous groups. Subgroup analysis revealed more Chinese having neuromyelitis optica and its spectrum disorders rather than multiple sclerosis. Positive family history was reported in 5%. Optic neuritis and myelitis were the commonest presentations at onset of disease, and relapsing remitting course was the commonest disease pattern observed. Oligoclonal band positivity was 57.6%. At disease onset, 61.5% and 66.4% fulfilled the 2005 and 2010 McDonald’s criteria for dissemination in space. Mean cord lesion length was 1.86 ± 1.65 vertebral segments in the relapsing remitting group as opposed to 6.25 ± 5.18 vertebral segments in patients with neuromyelitis optica and its spectrum disorders.Conclusion. The spectrum of multiple sclerosis in Malaysia has changed over the years. Further advancement in diagnostic criteria will no doubt continue to contribute to the evolution of this disease here.

Effects of BG-12 (dimethyl fumarate) on health-related quality of life in patients with relapsing–remitting multiple sclerosis: findings from the CONFIRM study

2013 ◽  
Vol 20 (2) ◽  
pp. 253-257 ◽  
Author(s):  
Mariko Kita ◽  
Robert J Fox ◽  
J Theodore Phillips ◽  
Michael Hutchinson ◽  
Eva Havrdova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Short Form ◽  
Dimethyl Fumarate ◽  
Phase Iii ◽  
Health Related Quality ◽  
Relapsing Remitting ◽  
Related Quality ◽  
Health Related

Multiple sclerosis (MS) has a significant impact on health-related quality of life (HRQoL) with symptoms adversely affecting many aspects of everyday living. BG-12 (dimethyl fumarate) demonstrated significant efficacy in the phase III studies DEFINE and CONFIRM in patients with relapsing–remitting MS. In CONFIRM, HRQoL was worse in patients with greater disability at baseline, and who relapsed during the study, and improved with BG-12 treatment. Mean Short Form-36 Physical Component Summary scores for BG-12 increased over 2 years and scores for placebo decreased. Coupled with clinical and neuroradiological benefits, these HRQoL results further support BG-12 as an effective oral treatment for relapsing MS.

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