Social handicaps of multiple sclerosis and their relation to neurological alterations

The social conditions of 73 patients with multiple sclerosis (MS) were studied in relation to the most common neurological disorders observed among them. The Environmental Status Scale (ESS) and Kurtzke's Neurological Functional System (NFS)--both included within the Minimal Record of Disability (MRD)--were used. Pyramidal alterations were the more frequent neurological findings, whereas the need for personal care was the most common social handicap. The chi 2 test applied to contrast each of the dicotomic ESS and NFS variables showed a significant relationship between pyramidal alteration (weakness) and the need for personal care (p < 0.001), the use of community services (p < 0.01), and transportation problems (p < 0.05). Cerebellar disorders were significantly related to the need for community services (p < 0.01) and transportation problems (p < 0.01). Vision disorders were significantly related to the need for personal care (p < 0.05), transportation problems (p < 0.05), and social activity (p < 0.05). In turn, spasticity was significantly related to the need for personal care (p < 0.001), financial (p < 0.001) and transportation problems (p < 0.001), laboral situation (p < 0.05), and the use of community services (p < 0.05). Contrasting the four NFS and 7 ESS nondicotomic variables showed a marked correlation between the pyramidal alterations and personal care (r = 0.71) and transport (r = 0.62). Pyramidal alterations influence the social situation of MS patients and may be the foremost alterations to be considered for the optimal social integration of these patients.