title: Multiple sclerosis: an essential review.
abstract: Clearly, MS can be associated with a host of burdensome, and sometimes progressive, symptoms. The therapeutic options for MS have been greatly enhanced over the past decade and research into more effective therapies continues to prosper. Prospects for new and more effective remedies remain promising. On the other hand, it is very important for the caregiver to rely on evidence-based therapeutic interventions when treating a patient with MS. For relapsing/remitting disease, the platform therapies of interferon beta and glatiramer acetate remain state-of-the-art. For progressive disease, the skilled clinician must recognize that empiric therapies with uncertain efficacy may remain the only option. Clinicians should also exhibit a commitment to address the varied array of symptoms that may hamper a patient's daily functioning. As the seasoned caregiver assists the patient over the irregular terrain of symptoms and treatment options, it is essential to recognize both the limitations of therapy and the importance of focused attention to the specifics of a patient's situation. Oftentimes in MS, as in other chronic conditions, sweeping changes that transform disability are not possible. Rather incremental interventions that attend to the intimacies of a patient's symptoms and concerns can reap significant benefits. Care for the patient with MS can serve as a paradigm for meaningful collaboration between clinician and patient as they strive to achieve balance. In those times of therapeutic uncertainty a commitment to caring can have an enduring influence.
authors.affiliation: Department of Neurosciences, Sanford School of Medicine of The University of South Dakota, USA.
authors.forename: Jerome W
authors.initials: JW
authors.lastname: Freeman
authors.forename: Joanne
authors.initials: J
authors.lastname: Landis
authors.forename: Michelle
authors.initials: M
authors.lastname: VanDemark
mesh_terms: D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013023:South Dakota