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A Review of the Current Medical Aspects of Multiple Sclerosis

care professionals to refamiliarize themselves with the latest information on multiple sclerosis. Information about multiple sclerosis in textbooks is slow to change, while new data is changing our perceptions and treatments of multiple sclerosis patients. For example, over 10 percent of patients referred to comprehensive multiple sclerosis centers do not have multiple sclerosis. The incidents of false positive diagnosis of multiple sclerosis in general rehabilitation centers is undoubtedly higher. Neurologic symptoms associated with a few scattered, small increased white matter signals on MRI do not make a diagnosis of multiple sclerosis. In patients with definite multiple sclerosis, many symptoms are not related to new lesions. For example, they may reflect a physiological response to temperature elevation related to urinary tract infection or emotional issues. These and many other issues make treating MS patients very challenging and difficult. While the natural history for many older MS patients is progressive neurologic impairment, rehabilitation technology can keep them at a high functional level. This chapter addresses issues related to caring for multiple sclerosis patients, which may differ significantly from some textbook perceptions of the disease.