Patient Encounter Part 3

After 3 years of treatment, CN has had one additional relapse, but otherwise is doing fairly well. At her routine clinic appointment, she describes some difficulty walking due to leg spasticity and urinary incontinence episodes that occur about twice a week.

What treatment options are available for spasticity, and which would you choose?

Should this patient's incontinence be treated? If so, what medication would you recommend?

Cognitive impairment and memory dysfunction can be troublesome, affecting 40% to 60% of patients. Treatment with ß-interferon has demonstrated improvement. Acetylcholinesterase inhibitors may also be beneficial.55

Phosphodiesterase type 5 inhibitors are effective for MS-induced erectile dysfunction.13 In women, vaginal dryness or dyspareunia may respond to lubricating jellies.

Outcome Evaluation

• Assess for improvement/recurrence of symptoms.

• Monitor for adverse effects of medications.

• Monitor for adherence.

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