Rehabilitation of patients with multiple sclerosis

Multiple sclerosis (MS) is one of the most common diseases capable of producing severe disability in the young adult population. In fact, only rheumatic disorders and trauma exceed MS in this respect. Because the total population of patients in the United States is probably 250,000 to 500,000 and as a substantial number suffer severe disability, MS is a disease of considerable social and economic impact. The authors discuss the treatment of many of the most troubling symptoms of MS, including disorders of gait, bladder and bowel, upper extremities, speech, and deglutition. Such treatment entails careful assessment of the patient's neurologic and other symptoms; knowledge of his or her intellectual, emotional, and social skills and demands; and an understanding of the patient's support network.