Physical medicine and rehabilitation clinics of North America
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Most patients with progressive MS will develop voiding dysfunction. In order to properly manage these patients, it is imperative to have a basic understanding of normal and abnormal bladder function. Based on history, physical examination, urinalysis, and renal function, diagnostic evaluation can be tailored to the individual. ⋯ Although there are many treatment options for patients with neurogenic bladders, it is imperative that therapy remain conservative and initially reversible because symptoms from MS tend to wax and wane over time. Long-term follow-up for patients with MS and neurogenic bladders is required to preserve renal function and avoid infections. A urologic program should be designed to promote continent, low-pressure bladder storage and controlled emptying while minimizing symptoms in a manner that promotes improved quality of life and self-esteem.
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Phys Med Rehabil Clin N Am · Aug 1998
ReviewMultiple sclerosis potpourri. Paroxysmal symptoms, seizures, fatigue, pregnancy, and more.
Several symptom complexes in multiple sclerosis (MS) are found in unusual circumstances but are characteristic of the disease. Most of these are amenable to treatment and will be confronted by the physiatrist treating patients who have MS. This article begins by addressing paroxysmal symptoms such as trigeminal neuralgia, paroxysmal dysarthria and ataxia, parathesia and pain, paroxysmal itching, and akinesia. Seizures, adventitious movements, fatigue, and complications related to pregnancy also are addressed.