2023 Sessions - CMSC Scholar

Assessment and Management of Complex Symptoms

Chair: Kathleen Costello, MS CRNP MSCN (Can Do Multiple Sclerosis)

Multiple sclerosis is an inflammatory and degenerative disease of the CNS. While advances in disease modifying therapies have positively altered the natural history of the disease, people are still impacted by ongoing symptoms, making usually activities more difficult or impossible. This session will provide assessment and management strategies for three symptoms that present significant challenges to the individual and for the provider. Sleep disorders, spasticity and pain can be particularly complex and difficult to effectively manage. Sleep problems in MS are often clinically underrecognized yet affect people with MS far more than the general population, ranging from 25% – 54%. Sleep disorders are associated with cognitive dysfunction, higher levels of daytime fatigue, poor quality of life and greater risk for vascular comorbidities. Early identification and treatment are important to prevent poor outcomes. Spasticity is common in MS, affecting nearly 80% of patients at some time in their life. Spasticity changes over the course of the disease due to ongoing damage of neural networks. Spasticity impacts mobility, produces significant pain, and often disrupts sleep. Accurate assessment and interventions are necessary to reduce the widespread impact of spasticity. Pain is experienced by >50% of people with MS; either neuromuscular or neuropathic, and impacts mobility, mood, sleep and usual activities. Effective treatments and management strategies are possible but are highly individualized and may take time to optimize. Each of these symptoms can impact the others, and all negatively impact function and quality of life. Timely and accurate assessment and management are important to functional outcomes and quality of life. Level of Information: Intermediate