Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cannabis (marijuana) has been proposed as treatment for a widening spectrum of medical conditions and has many properties that may be applicable to the management of amyotrophic lateral sclerosis (ALS). This study is the first, anonymous survey of persons with ALS regarding the use of cannabis. There were 131 respondents, 13 of whom reported using cannabis in the last 12 months. Although the small number of people with ALS that reported using cannabis limits the interpretation of the survey findings, the results indicate that cannabis may be moderately effective at reducing symptoms of appetite loss, depression, pain, spasticity, and drooling. Cannabis was reported ineffective in reducing difficulties with speech and swallowing, and sexual dysfunction. The longest relief was reported for depression (approximately two to three hours).
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PMID:Survey of cannabis use in patients with amyotrophic lateral sclerosis. 1505 8

Multiple sclerosis (MS) is a disease of the CNS with a challenging clinical course characterized by heterogeneous symptoms related to inflammation and demyelination. Disease-modifying agents (DMAs) are used to treat the related neuronal degradation. Certain symptoms occur regularly, although with variable frequency, regardless of treatment with DMAs. Because there is no cure for MS at this time, symptom management is critically important to quality of life. Symptoms commonly seen are spasticity, fatigue, sexual dysfunction, bladder dysfunction, pain, and cognitive dysfunction. Other symptoms include depression, bowel dysfunction, paroxysmal symptoms, and weakness. The symptom management model that provides optimal results for patients with MS is a multimodal approach using effective communication, patient education, physical modalities and activities, occupational and other therapies, and pharmacologic interventions. Individualizing treatment for each patient involves gaining control of symptoms as early as possible to prevent cycles of symptoms from developing.
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PMID:A multimodal approach to managing the symptoms of multiple sclerosis. 1559 31

Multiple sclerosis (MS) is associated with a variety of symptoms and functional deficits that result in a range of progressive impairments and handicap. Symptoms that contribute to loss of independence and restrictions in social activities lead to continuing decline in quality of life. Our aim is to give an updated overview on the management of symptoms and rehabilitation measures in MS. Appropriate use of these treatment options might help to reduce long-term consequences of MS in daily life. First, we review treatment of the main symptoms of MS: fatigue, bladder and bowel disturbances, sexual dysfunction, cognitive and affective disorders, and spasticity. Even though these symptomatic therapies have benefits, their use is limited by possible side-effects. Moreover, many common disabling symptoms, such as weakness, are not amenable to drug treatment. However, neurorehabilitation has been shown to ease the burden of these symptoms by improving self-performance and independence. Second, we discuss comprehensive multidisciplinary rehabilitation and specific treatment options. Even though rehabilitation has no direct influence on disease progression, studies to date have shown that this type of intervention improves personal activities and ability to participate in social activities, thereby improving quality of life. Treatment should be adapted depending on: the individual patient's needs, demands of their surrounding environment, type and degree of disability, and treatment goals. Improvement commonly persists for several months beyond the treatment period, mostly as a result of reconditioning and adaptation and appropriate use of medical and social support at home. These findings suggest that quality of life is determined by disability and handicap more than by functional deficits and disease progression.
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PMID:Symptomatic therapy and neurorehabilitation in multiple sclerosis. 1616 33

Many people with MS suffer from severe and disabling symptoms that restrict their social and private lives, and hence affect their quality of life; it is, therefore, essential that any symptoms that they experience are reduced effectively. Symptomatic treatment should also aim to prevent secondary complications that may result from existing disabilities. Since many MS patients are unaware that some of their complaints may be attributable to MS, e.g. fatigue, sexual dysfunction, pain or dysphagia, all patients should be thoroughly questioned about all healthcare issues and the results must be documented. In recent months, several studies about the treatment of important MS symptoms--like spasticity, pain, fatigue, bladder and sexual dysfunction, depression and cognitive impairment--have been published; this article will briefly summarize and discuss some of these treatments.
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PMID:What is new in symptom management? 1750 49

Disease progression and advancing disability will supervene in the majority of multiple sclerosis patients who are followed over the long-term. This process can begin insidiously from the onset of the disease (primary progression) or after one or more clinical flares (secondary progression). The factors which lead to progression of disability are incompletely understood. The progressive forms of multiple sclerosis have been remarkably resistant to treatment. The legacy of heroic immunosuppression as a treatment for the disease progression has been modest indeed although there is some recent enthusiasm for immunosuppression with agents like mitoxantrone. In the last decade, the treatment of relapsing forms of multiple sclerosis has been revitalised by the interferons and glatiramer acetate. The robust treatment effect on the magnetic resonance imaging burden of the disease and the modest treatment effect in the suppression of clinical attacks have raised hopes that these agents might stall the disease in its progressive phase. Recent clinical trials with the interferons are indeed showing promise for modest clinical efficacy in patients selected for treatment on the basis of chronic progression. Given the weakness of the current treatment, the essence of disease management remains the handling of the complications of the disease. The management of bladder disturbances, spasticity, pain, depression, emotional lability, paroxysmal disorders, fatigue and heat intolerance, tremor and sexual dysfunction is reviewed.
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PMID:Treatment of secondary progressive multiple sclerosis: current recommendations and future prospects. 1803 Nov 81

Multiple sclerosis (MS) is the most common cause of progressive neurological disability in young adults. In addition to spasticity, tremors, weakness, sensory disturbances, depression, cognitive problems, and bladder or bowel dysfunction, sexual dysfunction (SD) is also a prevalent and destructive manifestation of the disease that severely affects quality of life. Evaluation of this disorder requires insight into the primary (changes that directly affect libido, sexual response and orgasm due to direct damage to the nervous system), secondary (complaints which are related to the physical disability of MS, such as fatigue, muscle rigidity, weakness and spasms), and tertiary (emotional, social and cultural aspects of MS) components of MS-associated SD. Given the complexity and multifactorial nature of SD, a multidisciplinary approach is necessary when treating patients with MS. The aim of this Review is to provide a holistic approach to the evaluation and management of SD in patients with MS, incorporating the latest data from the fields of urology, neurology, nursing, social work, and psychology. What is currently known regarding the evaluation and management of SD in patients with MS will be presented from the perspective of these specialties.
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PMID:Sexual dysfunction in patients with multiple sclerosis: a multidisciplinary approach to evaluation and management. 1919 23

Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs.
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PMID:Improving quality of life in multiple sclerosis: an unmet need. 2176 52

Stroke is the leading cause of disability and one of the most common causes of death worldwide. Outside the setting of acute management, secondary prevention and stroke rehabilitation, little has been written to address the ongoing symptomatic and palliative needs of these patients and their families. In this literature review, we look beyond secondary prevention with the aim of providing evidence-informed management guidelines for the myriad and often under-recognized symptomatic and palliative care needs of stroke survivors. Some of the most common and disabling post-stroke symptoms that are reviewed here include central post-stroke pain, hemiplegic shoulder pain, painful spasticity, fatigue, incontinence, post-stroke seizures, sexual dysfunction, sleep-disordered breathing, depression and emotionalism. We review the role of caregivers and explore ways to support them and, lastly, remind the reader to be perceptive to the patient's spiritual needs. The literature is most robust, including controlled trials, for central post-stroke pain and depression. Synthesis and discussion outside these areas are frequently limited to smaller studies, case reports and expert opinion. While some data exists to guide informed decision-making, there is an urgent need to document best practice and identify appropriate clinical standards for the full spectrum of symptoms experienced by stroke survivors. We present the current and established data to aid health care providers in symptomatic and palliative management of stroke survivors.
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PMID:Symptomatic and palliative care for stroke survivors. 2252 22

There are many different paths that lead to an academic physiatric career and a lifelong interest in spinal cord injury (SCI) medicine. It is unfortunate that after decades of cellular-based research in multiple laboratories, there are still no interventions available that can reverse the neurologic loss that follows SCI. In contrast, medical rehabilitation research during the last 40 yrs has led to remarkable improvements in the lives of persons with SCI as evident in their increased life expectancy, shorter hospitalizations, fewer rehospitalizations, and more effective treatments for male sexual dysfunction and fertility, as well as spasticity, heterotrophic ossification, and neuropathic pain. Application of modern technology has improved the mobility of persons with SCI with better designed wheelchairs, decreased their dependency on others, facilitated their access to information, made communication and community integration easier, and so on. Although deaths related to urinary tract complications are now rare, better methods of managing the neurogenic bladder are still needed. Furthermore, better management methods are also needed for the neurogenic bowel, SCI pain, and osteoporosis of the paralyzed limbs. Even with proper prophylaxis, deep vein thrombosis and pulmonary embolism are still common, and clinicians have paid too little attention to reducing the risk for persons with SCI of developing obesity, diabetes mellitus, and cardiovascular disease. These challenges need to be met by medical rehabilitation research, by advocating for insurance policies that support the healthcare needs of persons with SCI, and by developing comprehensive disability policies, all with the support and leadership of academic physiatrists.
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PMID:Medical rehabilitation of people with spinal cord injury during 40 years of academic physiatric practice. 2231 33

Despite the important advances being made in disease-modifying multiple sclerosis (MS) therapies, patients are often affected by a wide variety of symptoms caused by neurologic injury in MS. Common symptoms that patients with MS experience during the course of their illness include weakness, ambulatory impairment, sensory disturbances that may be unpleasant or even painful, ataxia and tremor, bladder and bowel dysfunction, sexual dysfunction, fatigue, spasticity, vertigo, depression and other psychiatric symptoms, cognitive impairment, and paroxysmal symptoms such as cramps, spasms, Lhermitte symptom, and Uhthoff phenomenon. These MS symptoms can cause loss of vocation and social isolation. Neurologic care of patients with MS often involves a greater degree of management of the symptoms caused by MS than appropriate prescription of disease-modifying treatments. In addition, many of the disease-modifying therapies have unpleasant side effects that may also require treatment. This article will focus on medical treatments, use of rehabilitation medicine, and, in select cases, surgical interventions for management of MS symptoms.
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PMID:Symptomatic therapy of multiple sclerosis. 2281 Jun


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