**Author details**

There is also a relationship between the duration of natalizumab therapy and an increased

Rituximab is a monoclonal antibody. It selectively depletes CD20+ B lymphocytes. There have been no controlled, randomized trials. Salzer et al. suggested that rituximab treatment is safe,

Trials on the safety and efficacy of new oral therapies including fingolimod, dimethyl fuma‐

Spasticity, fatigue, tremor, neuropathic pain, paroxysmal symptoms, epileptic seizures, bladder dysfunctions, and depression can be persistent symptoms in MS and affect patient's quality of life. Medical drugs can be effective in the treatment of these symptoms as in adult

Baclofen, tizanidine, and benzodiazepines are effective for spasticity. Amantadine, modafinil, methylphenidate can be used for fatigue. Antiepileptic drugs such as carbamazepine, gaba‐ pentine are effective for both paroxysmal symptoms and neuropathic pain [42]. Anticholiner‐ gic agents (oxybutynin, tolterodine) can be used for detrusor hyperreflexia, and desmopressin

The aim of MS rehabilitation is to reduce symptoms including spasticity, gait disturbances, imbalance, bladder-bowel dysfunction, speech and swallowing disorders, fatigue, pain and improve quality of life. Rehabilitation interventions for MS symptoms include methods such as exercise (stretching/strengthening), gait training, endurance training, aerobic training, hydrotherapy, physiotherapy, exercise-pelvic floor training, occupational therapy, psycho‐ logical training [46]. Rehabilitation interventions should be selected according to patient's

Cognitive rehabilitation is an important part of MS rehabilitation, but there is no specific cognitive rehabilitation intervention for pediatric MS. Rehabilitative strategies include rehabilitation of attention and language based on other disease such as trauma, stroke, and

Two to 5% of all MS patients have their first attack during childhood or adolescence. Pediatric MS has different clinical features from adult-onset MS, particularly in very young children. ADEM can occur as first attack in children, especially those under 10 years of age. The relapse rate in pediatric MS is higher than in adult MS, but recovery from relapse is better than in adults. However, the onset of secondary progression occurs at a younger age as compared

risk. There have been no controlled, randomized trials in pediatric MS to date.

effective, and well tolerated in their case series with pediatric MS [45].

rate, and teriflunamide in pediatric MS patients have not been finalized.

**10.3. Symptomatic treatment**

180 Trending Topics in Multiple Sclerosis

may be beneficial for nocturia.

characteristics such as age and functional deficits.

**10.4. Rehabilitation**

tumor [47].

**11. Conclusion**

patients.

#### Ozgul Ekmekci

Address all correspondence to: ozgul.ekmekci@ege.edu.tr

Ege University, Faculty of Medicine, Department of Neurology, Izmir, Turkey

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