Symptomatic Therapy and Rehabilitation in Primary Progressive Multiple Sclerosis

Box 4

Challenges in MS rehabilitation.

(i)  MS is dynamic with a complex moving target of deficits.

(ii) Unpredictable disease progression and lesion distribution makes it difficult for the patient to adjust and use

compensatory strategies.

(iii) Covert symptoms (fatigue, diplopia) can be disabling but not visible to others.

(iv) Profound sense of vulnerability, loss of control, and grieving underlies the coping process.