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Chapter 18 - Movement disorders in multiple sclerosis

from Section IV - Movement disorders in general neurology

Published online by Cambridge University Press:  05 April 2014

By
Marcelo Merello  and
Angelo Antonini
Edited by
Werner Poewe  and
Joseph Jankovic
Marcelo Merello
Affiliation:
Department of Neuroscience FLENI and Universidad Católica (UCA), Buenos Aires, Argentina
Angelo Antonini
Affiliation:
UO Malattia Parkinson, IRCCS San Camillo Venezia e Neurologia, AO University Padova, Padova, Italy
Werner Poewe
Affiliation:
Medical University Innsbruck
Joseph Jankovic
Affiliation:
Baylor College of Medicine, Texas
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Summary

Introduction

Multiple sclerosis (MS) is the main cause of non-traumatic chronic disability in young adults with neurological disorders (Ramagopalan and Sadovnick 2011). Clinical manifestations are provoked by multifocal demyelination and axonal damage in multiple areas of the CNS, causing functional deficit or negative symptoms; positive symptoms completing the clinical spectrum include neuropathic pain and paroxysmal phenomena resulting from inappropriate axon response (Smith and McDonald 2003).

MS presents as one of four distinct clinical variants or forms: relapsing remitting, primary progressive, secondary progressive, or progressive relapsing. Approximately 87 percent of patients show the relapsing remitting form, characterized by acute attacks (relapses), followed by partial or full recovery (remissions) (Weiner 2008). Patients can manifest with a heterogeneous group of symptoms, including changes in vision, lack of coordination, sensory distortion or loss, or changes in bowel or bladder function.

Specific immunomodulatory therapies have shown significant impact on MS natural history. However, even when agents reduce relapse rates and MRI-associated disease activity, they are only partially effective, and do not ameliorate the irreversible axonal damage underlying the most significant symptomatic burden. MS-associated symptom treatment remains an essential cornerstone of comprehensive care for affected patients.

Type
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Information
Movement Disorders in Neurologic and Systemic Disease , pp. 268 - 278
Publisher: Cambridge University Press
Print publication year: 2014

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  • Movement disorders in multiple sclerosis
    • By Marcelo Merello, Department of Neuroscience FLENI and Universidad Católica (UCA), Buenos Aires, Argentina, Angelo Antonini, UO Malattia Parkinson, IRCCS San Camillo Venezia e Neurologia, AO University Padova, Padova, Italy
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.019
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  • Movement disorders in multiple sclerosis
    • By Marcelo Merello, Department of Neuroscience FLENI and Universidad Católica (UCA), Buenos Aires, Argentina, Angelo Antonini, UO Malattia Parkinson, IRCCS San Camillo Venezia e Neurologia, AO University Padova, Padova, Italy
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.019
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  • Movement disorders in multiple sclerosis
    • By Marcelo Merello, Department of Neuroscience FLENI and Universidad Católica (UCA), Buenos Aires, Argentina, Angelo Antonini, UO Malattia Parkinson, IRCCS San Camillo Venezia e Neurologia, AO University Padova, Padova, Italy
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.019
Available formats
×