title: Need for symptomatic management in advanced multiple sclerosis.
abstract: OBJECTIVE
  A majority of patients with advanced multiple sclerosis (MS) need symptomatic treatment. Many MS-related symptoms may not be recognized and thus are not treated. We conducted a study to estimate the prevalence of inadequate symptomatic treatment of patients with advanced MS.
  
  
  METHODS
  Patients with advanced MS admitted to a specialist MS rehabilitation clinic were included in this study. Severity was assessed using the Expanded Disability Status Scale (EDSS). The information we collected included age of onset, initial course, time to sustained disability, pharmacological treatment, degree of spasticity, pain and bladder dysfunction, and unmet needs of symptomatic treatment.
  
  
  RESULTS
  In total, we assessed demographic and clinical characteristics in 129 patients with a mean age of 56 years and a median EDSS of 7.5. The proportion with inadequate symptom treatment was regarding spasticity 46%, pain 28%, and bladder dysfunction 23%.
  
  
  CONCLUSIONS
  This study showed that a large proportion of patients with advanced MS had lack of symptomatic treatment. These patients probably underuse neurological specialist services. Better symptomatic treatment could contribute to improving quality of life of people with MS.
authors.affiliation: Department of Neurology, Akershus University Hospital, Lørenskog, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: O M
authors.initials: OM
authors.lastname: Rønning
authors.affiliation: Eiksåsen Multiple Sclerosis Rehabilitation Centre, Baerum, Norway.
authors.forename: K D
authors.initials: KD
authors.lastname: Tornes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009128:Muscle Spasticity / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009664:Norway / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index
keywords: multiple sclerosis; pain; spasticity; symptomatic treatment