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[2008 updates are highlighted in red]
General Reviews • Brichetto G, Uccelli MM, Mancardi GL, Solaro C. Symptomatic medication use in multiple sclerosis. Multiple Sclerosis 2003; 9:458–460. • Henze T, Toyka KV, Rieckmann P. Symptomatic treatment of multiple sclerosis. European Neurology, 2006;56:78-105. • Kesselring J, Beer S. Symptomatic therapy and neurorehabilitation in multiple sclerosis. Lancet Neurology 2005;4:643-652. • Khan F, Turner-Stokes L, Ng L, Kilpatrick T. Multidisciplinary rehabilitation for adults with multiple sclerosis (review). The Cochrane Library 4, The Cochrane Collaboration, Wiley, 2007. • National Institute for Clinical Excellence. Multiple Sclerosis: Management of multiple sclerosis in primary and secondary care. Clinical Guideline 8. 2003. • Thompson AJ. Symptomatic management and rehabilitation in multiple sclerosis. J Neurol Neurosurg Psychiatry 2001; 71(Suppl II):ii22–ii27. • Thompson AJ. Neurorehabilitation in multiple sclerosis: foundations, facts and fiction. Curr Opin Neurol 2005; 18: 267–271. • World Health Organization. Neurological Disorders. Public health challenges. WHO, Geneva, 2006, 217 pp.
Symptomatic Management
Spasticity • Beard S, Hunn A, Wight J. Treatments for spasticity and pain in multiple sclerosis: a systematic review. Health Technol Assess. 2003; 7(40): iii, ix–x, 1–111. • Giovannelli M, Borriello G, Castri P, Prosperini L, Pozzilli C. Early physiotherapy after injection of botulinum toxin increases the beneficial effects on spasticity in patients with multiple sclerosis. Clin Rehabil 2007;21:331-337. • Hymen N, Barnes B, Bhakta B, et al. Botulinum toxin treatment of hip adductor spasticity in multiple sclerosis: A prospective, randomized, double blind, placebo controlled dose ranging study. J Neurol Neurosurg Psychiatry 2000; 68:707–712. • Jarrett L, Nandi P, Thompson AJ. Managing severe lower limb spasticity in multiple sclerosis: does intrathecal phenol have a role? J Neurol, Neurosurg and Psychiatry 2002; 73:705–709. • Killestein J, Hoogervorst ELJ, Reif M, et al. Safety, tolerability and efficacy of orally administered cannabinoids in MS. Neurology 2002; 58:1404–1407. • Multiple Sclerosis Council for Clinical Practice Guidelines. Spasticity Management in Multiple Sclerosis. Published by Consortium of MS Centres. 2003. • Ochs G, Struppler A, Meyerson BA, et al. Intrathecal baclofen for long-term treatment of spasticity: A multicentre study. J Neurol Neurosurg Psychiatry 1989; 52: 933–939. • Paisley S, Beard S, Hunn A, Wight J. Clinical effectiveness of oral treatments for spasticity in multiple sclerosis. Multiple Sclerosis 2002; 8:319–329. • Salame K, Ouaknine GE, Rochkind S, Constantini S, Razon N. Surgical treatment of spasticity by selective posterior rhizotomy: 30 years experience. Isr Med Assoc J 2003; 5:543–546. • Shakespeare DT, Boggild M, Young C. Anti-spasticity agents for multiple sclerosis. Cochrane Database Syst Rev 2003; (4):CD001332. • Sheean G. Pathophysiology of spasticity. In: Sheean G (ed.). Spasticity Rehabilitation. Edinburgh: Churchill Communications Europe Ltd., 1998:17–38. • Thompson AJ, Jarrett L, Lockley L, Marsden J, Stevenson V. Clinical management of spasticity. J Neurol Neurosurg Psychiatry 2005; 76:459–463. • Vaney C, Heinzel-Gutenbrunner M, Jobin P, Tschopp F, Gattlen B, Hagen U, Schnelle M, Reif M. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled, crossover study. Multiple Sclerosis 2004; 10:417–424. • Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, Thompson A, UK MS Research Group. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): Multicentre randomized placebo-controlled trial. Lancet 2003; 362:1517–26. • Zajicek J, Sanders HP, Wright DE, Vickery J, Ingram W, Reilly S, Nunn A, Thompson A. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow-up. J Neurol Neurosurg Psychiatry 2005;76:1664-1669.
Ataxia • Alusi SH, Glickman S, Aziz TZ, Bain PG. Tremor in multiple sclerosis. (Editorial) J Neurol Neurosurg Psychiatry 1999; 66:131–134. • Alusi SH, Aziz TZ, Glickman S, Jahanshahi M, Stein JF, Bain PG. Stereotactic lesional surgery for the treatment of tremor in multiple sclerosis: A prospective case-controlled study. Brain 2001; 124:1576–1589. • Fox P, Bain PG, Glickman S, Carroll C, Zajicek J. The effects of cannabis on tremor in patients with multiple sclerosis. Neurology 2004; 62:1105–1109. • Mills RJ, Yap L, Young CA. Treatment for ataxia in multiple sclerosis. Cochrane Database Syst Rev 2007;(1):CD005029. • Montgomery EB, Baker KB, Kinkel RP, Barnett G. Chronic thalamic stimulation for the tremor of multiple sclerosis. Neurology 1999; 53:625–628. • Rice GPA, Lescaux J, Ebers G. Ondansetron versus placebo for disabling cerebellar tremor: Final report of a randomized clinical trial. Ann Neurol 1999; 46:493. • Schuurman PR, Andries Bosch D, Dossuyt PMM, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N. Engl J Med 2000; 343:461–468. • Wishart HA, Roberts DW, Roth RM et al. Chronic deep brain stimulation for the treatment of tremor in multiple sclerosis: Review and case reports. J Neurol Neurosurg and Psychiatry 2003; 74:1392–1397.
Fatigue • Bakshi R. Fatigue associated with multiple sclerosis: Diagnosis, impact and management. Multiple Sclerosis 2003; 9:219–227. • Comi G, Leocani L, Rossi P, Colombo B. Physiopathology and treatment of fatigue in multiple sclerosis. J Neurol 2001; 248:174–179. • Gillson G, Richard TL, Smith RB, Wright JV. A double blind pilot study of the effect of Prokarin on fatigue in multiple sclerosis. Multiple Sclerosis 2002; 8:30–35. • Krupp LB, Coyle PK, Doscher C, et al. Fatigue therapy in multiple sclerosis: Results of a double-blind, randomized, parallel trial of amantadine, pemoline, and placebo. Neurology 1995; 45(11):1956–1961. • Metz LM, Patten SB, Archibald CJ, et al. The effect of immunomodulatory treatment on multiple sclerosis fatigue. J Neurol Neurosurg and Psychiatry 2004; 75:1045–1047. • Multiple Sclerosis Council for Clinical Practice Guidelines. Fatigue and Multiple Sclerosis. Washington, DC: Paralyzed Veterans of America, 1998. • Rammohan KW, Rosenberg JH, Lynn DJ, Blumenfeld AM, Pollak CP, Nagaraja HN. Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. J Neurol Neurosurg Psychiatry 2002; 72:179–183. • Van Diemen HA, Polman CH, van Dongen TM, et al. The effect of 4-aminopyridine on clinical signs in multiple sclerosis: A randomized, placebo-controlled, doubleblind, cross-over study. Ann Neurol 1992; 32(2): 123–130.
Bladder, Bowel and Sexual Dysfunction • Dasgupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies Drugs 2003; 63:153–166. Bladder Dysfunction • Betts CD, D’Mellow MT, Fowler CJ. Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 1993; 56(3):245–250. • Brady CM, Dasguta R, Dalton C, Wiseman OJ, Berkley KJ, Fowler CJ. An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis. Multiple Sclerosis 2004; 10:425–433. • Fowler CJ. Investigation of the neurogenic bladder. J Neurol Neurosurg Psychiatry 1996; 60:6–13. • Harper M, Fowler CJ, Dasgupta P. Botulinum toxin and its applications in the lower urinary tract. BJU Int. 2004; 93:702–704. • Kalsi V, Gonzales G, Popat R, Apostolidis A, Elneil S, Dasgupta P, Fowler CJ. Botulinum injections for the treatment of bladder symptoms of multiple sclerosis. Ann Neurol 2007; 62:452-457. • MS Council for Clinical Practice Guidelines. Urinary Dysfunction and Multiple Sclerosis. Evidence-Based Management Strategies for Urinary Dysfunction in Multiple Sclerosis. Washington, DC: Paralyzed Veterans of America, 1998. • Vahtera T, Haaranen M, Viramo-Koskela AL, Ruutiainen J. Pelvic floor rehabilitation is effective in patients with multiple sclerosis. Clin Rehabil 1997; 11:211–219. • Valiquette G, Herbert J, Maede D. Desmopressin in the management of nocturia in patients with multiple sclerosis. A double-blind, crossover trial. Arch Neurol 1996; 53:1270–1275. •
Bowel Dysfunction • Fowler CJ, Henry MM. Gastrointestinal dysfunction in MS. Semin Neurol 1996; 16:277–279. • Hinds JP, Eidelman BH, Wald A. Prevalence of bowel dysfunction in MS. Gastroenterology 1990; 98:1538–1542.
Sexual Dysfunction • Betts CD, Jones SJ, Fowler CG, Fowler CJ. Erectile dysfunction in multiple sclerosis: Associated neurological and neurophysiological deficits, and treatment of the condition. Brain 1994; 117:1303–1310. • Carson C, Hatzichristou D, Carrier S, et al. Erectile response with vardenafil in sildenafil non-responders: A multi-centre, double-blind, 12-233k, flexible-dose, placebo-controlled erectile dysfunction clinical trial. BJU International 2004; 94:1301–1309. • Carson C, Rajfer J, Eardley I, et al. The efficacy and safety of tadalafil: an update. BJU International 2004; 93:1276–1281. • Dasgupta R, Wiseman OJ, Kanabar G, Fowler CF, Mikol DD. Efficacy of sildenafil in the treatment of female sexual dysfunction due to multiple sclerosis. J Urol 2004; 171:1189–1193. • Foley FW, LaRocca NG, Sanders AS, Zemon V. Rehabilitation of intimacy and sexual dysfunction in couples with multiple sclerosis. Multiple Sclerosis 2001; 7:417–421. • Zorzon M, Zivadinov R, Bosco A, et al. Sexual dysfunction in multiple sclerosis: A case-control study. 1. Frequency and comparison of groups. Multiple Sclerosis 1999; 5:418–427.
Pain • Archibald CJ, McGrath, PJ, Ritvo PG, et al. Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients. Pain 1994; 58:89–93. • Berk C, Constantoyannis C, Honey CR. The treatment of trigeminal neuralgia in patients with multiple sclerosis using percutaneous radiofrequency rhizotomy. Can J Neurol Sci 2003; 30:320–323. • Broggi G, Ferroli P, Franzini A, Servello D, Dones I. Microvascular decompression for trigeminal neuralgia: Comments on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2000; 68:59–64. • DMKG Study group. Misoprostol in the treatment of trigeminal neuralgia associated with multiple sclerosis. J Neurol 2003; 250:542–545. • Ehde DM, Gibbons LE, Chwastiak L, Bombardier CH, Sullivan MD, Kraft GH. Chronic pain in large community sample of persons with multiple sclerosis. Multiple Sclerosis 2003; 9:605–611. • Eldridge PR, Sinha AK, Javadpour M, Littlechild P, Varma TR. Microvascular decompression for trigeminal neuralgia In patients with multiple sclerosis. Stereotact Funct Neurosurg 2003; 81:57–64. • Khan OA. Gabapentin relieves trigeminal neuralgia in multiple sclerosis patients. Neurology 1998; 51:611–614. • Svendsen KB, Jensen TS, Bach FW. Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomized double-blind placebo-controlled crossover trial. Br Med J. 2004; 329:253–256. • Svendsen KB, Jensen TS, Overvad K, Hansen HJ, Koch-Henriksen N, Bach FW. Pain in patients with multiple sclerosis: A population-based study. Arch Neurol 2003; 60:1089–1094.
Cognitive Dysfunction • Jonnsson A, Korfitzen EM, Heltberg A, Ravnborg MH, Byskov-Ottosen E. Effects of neuropsychological treatment in patients with multiple sclerosis. Acta Neurol Scand 1993; 88:394–400. • Krupp LB, Christodoulou C, Melville P, Scherl WF, MacAllister WS, Elkins LE. Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology 2004; 63:1579–1585. • Parry AM, Scott RB, Palace J, Smith S, Matthews PM. Potentially adaptive functional changes in cognitive processing for patients with multiple sclerosis and their acute modulation by rivistigmine. Brain 2003; 126:2750–1760. • Plohmann AM, Kappos L, Ammann W, et al. Computer assisted retraining of attentional impairments in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 1998; 64:455–462. • Solari A, Motta A, Mendozzi L, Pucci E, Forni M, Mancardi G, Pozzilli C. Computer-aided retraining of memory and attention in people with multiple sclerosis: A randomized double-blind controlled trial. J Neurol Sci 2004; 222:99–104.
Psychological and Psychiatric Dysfunction • Feinstein A. The neuropsychiatry of multiple sclerosis. Can J Psychiatry 2004; 49:157–63. • Feinstein A, Roy P, Lobaugh N, Feinstein K, O’Connor P, Black S. Structural brain abnormalities in multiple sclerosis patients with major depression. Neurology 2004; 62:586–90. • Ron MA, Logsdail SJ. Psychiatric morbidity in multiple sclerosis: A clinical and MRI study. Psychol Med 1989; 19:887–895.
Other Symptoms • Abraham S, Scheinberg LC, Smith CR, LaRocca NG. Neurologic impairment and disability status in outpatients with multiple sclerosis reporting dysphagia symptomatology. J Neuro Rehab 1997; 11(1):7–13. • Howard RS, Wiles CM, Hirsch NP, et al. Respiratory involvement in multiple sclerosis. Brain 1992; 115: 479–494. • Schwid SR, Petrie MD, Murray R et al. A randomized controlled study of the acute and chronic effects of cooling therapy for MS. Neurology 2003; 60:1955–1960. • Starck M, Albrecht H, Pollmann W, Straube A, Dieterich M. Drug therapy for acquired pendular nystagmus in multiple sclerosis. J Neurol 1997; 244:9–16. Neurorehabilitation
General Reviews • European Multiple Sclerosis Platform. Recommendations on Rehabilitation Services for Persons with Multiple Sclerosis in Europe. Associazione Italiana Scelosi Multipla. Genoa Italy, October 2004. • Freeman J, Ford H, Mattison P, Thompson AJ, Ridley J, Haffenden S. Developing MS Healthcare Standards: Evidence-Based Recommendations for Service Providers. MS Society of Great Britain and Northern Ireland, 2002. • Multiple Sclerosis International Federation. Principles to Promote the Quality of Life of People with Multiple Sclerosis. Multiple Sclerosis International Federation (MSIF), London, 2005, 63 pp. • Thompson AJ. The effectiveness of neurological rehabilitation in multiple sclerosis. J Rehabil Res Dev. 2000; 37:455–461. Outcome Measures • Fischer JS, LaRocca NG, Miller DM, et al. Recent developments in the assessment of quality of life in multiple sclerosis (MS). Multiple Sclerosis 1999; 5:251–260. • Hobart JC, Cano SJ, Zajicek JP, Thompson AJ. Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. Lancet Neurology 2007 ;2007; 6 :6:1094-1105. • Hobart JC, Lamping DL, Fitzpatrick R, Riazi A, Thompson AJ. The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain 2001; 124:962–973. • Hobart JC, Riazi A, Lamping DL, Fitzpatrick R, Thompson AJ. Measuring the impact of MS on walking ability: The 12-item MS Walking Scale (MSWS-12). Neurology 2003; 31–36. • Jonsson A, Dock J, Ravnborg MH. Quality of life as a measure of rehabilitation outcome in patients with multiple sclerosis. Acta Neurol Scand 1996; 93:229–235. • Rossiter DA, Edmondson A, Al-Shahi R, Thompson AJ. Integrated care pathways in multiple sclerosis: Completing the audit cycle. Multiple Sclerosis 1998; 4:85–89. • Sharrack B, Hughes RAC, Soudain S, Dunn G. The psychometric properties of clinical rating scales used in multiple sclerosis. Brain 1999; 122:141–160. • Thompson AJ, Hobart JC. Multiple sclerosis: Assessment of disability and disability scales. J Neurol 1998; 245(4):189–196. • Vickrey BG, Hays RD, Harooni R, Myers LW, Ellison GW. A health-related quality of life measure for multiple sclerosis. Qual Life Res 1995; 4(3):187–206.
Diagnostic Phase • De Groot V, Beckerman H, Twisk JW, Uitdehaag BM, Hintzen RQ, Minneboo A, Lankhorst GJ, Polman CH, Bouter LM. Vitality, perceived social support and disease activity determine the performance of social roles in recently diagnosed multiple sclerosis: a longitudinal analysis. J Rehabil Med 2008; 40:151-157. • McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50:121–127. • Polman CH, Reingold SC, Edan G, Filippi M, Hartung H-P, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandverg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Annals of Neurology 2005;58:840-846. • Porter B, Keenan E, Record E, Thompson AJ. Diagnosis of MS: A comparison of three different clinical settings. Multiple Sclerosis 2003; 9:431–439.
Minimal Disability • Chataway J, Porter B, Riazi A, Heaney D, Watt H, Hobart J, Thompson A. Home versus outpatient administration of intravenous steroids for multiple sclerosis relapses: a randomised controlled trial. Lancet Neurology 2006;5:565-571. • Craig J, Young CA, Ennis M, Baker G, Boggild M. A randomized, controlled trial comparing rehabilitation against standard therapy in multiple sclerosis patients receiving intravenous steroid therapy treatment. J Neurol, Neurosurg Psychiatry 2003; 74:1225–1230. • Dalgas U, Stenager E, Ingemann-Hansen T. Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training. Multiple Sclerosis 2008;14:35-53. • Liu C, Playford D, Thompson AJ. Does neurorehabilitation have a role in relapsing-remitting multiple sclerosis? J Neurol 2003; 250:1214–1218. • Lublin FD, Baier M, Cutter G. Effect of relapses on the development of residual deficit in multiple sclerosis. Neurology 2003; 61:1528–1532. • Mostert S, Kesselring J. Effects of short-term exercise training programme on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Multiple Sclerosis 2002; 8:161–168. • Motl RW, Gosney JL. Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis. Multiple Sclerosis 2008;14(1):129-135. • Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39(4):432–441. • Rietberg MB, Brooks D, Uitdehaag BMJ, Kwakkel G. Exercise therapy for multiple sclerosis (review). The Cochrane Library 4, The Cochrane Collaboration, Wiley, 2007 • Romberg A, Virtanen A, Aunola S, Karppi S. Exercise capacity, disability and leisure physical activity of subjects with multiple sclerosis. Multiple Sclerosis 2004; 10:212–218. • Romberg A, Virtanen A, Ruutianen J, Aunola S, Karppi S-L, Vaara M, Surakka J, Pohjolainen T, Seppänen A. Effects of a six-month exercise programme on patients with MS. Neurology 2004;63:2034-2038. • Steultjens EM, Dekker J, Bouter LM, Cardol M, Van de Nes JC, Van den Ende CH. Occupational therapy for multiple sclerosis. Cochrane Database Syst Rev 2003 ;(3):CD003608. • Sweetland J, Riazi A, Cano SJ, Playford ED. Vocational rehabilitation services for people with multiple sclerosis: what patients want from clinicians and employers. Multiple Sclerosis 2007;13(9):1183-1189. • Thomas PW, Thomas S, Hillier C, Galvin K, Baker R. Psychological interventions for multiple sclerosis. Cochrane Database Syst Rev 2006 ;(1):CD004431. • Wiles CM, Newcombe RG, Fuller KJ, et al. A controlled, randomized, crossover trial of the effects of physiotherapy on mobility on chronic multiple sclerosis. J Neurol Neurosurg Psychiat 2001;70:174-179.
Moderate Disability • Aisen ML, Sevilla D, Fox N. Inpatient rehabilitation for multiple sclerosis. J Neuro Rehab 1996; 10:43–46. • Di Fabio RP, Soderberg J, Choi T, Hansen CR, Schapiro RT. Extended outpatient rehabilitation: Its influence on symptom frequency, fatigue and functional status for persons with progressive multiple sclerosis. Arch Phys Med Rehabil 1998; 79(2):141–146. • Freeman JA, Langdon DW, Hobart JC, Thompson AJ. Inpatient rehabilitation in multiple sclerosis: Do the benefits carry over into the community? Neurology 1999; 52:50–56. • Freeman JA, Langdon DW, Hobart JC, Thompson AJ. The impact of inpatient rehabilitation on progressive multiple sclerosis. Ann Neurol 1997; 42(2):236–244. • Grasso MG, Troisi E, Rizzi F, Morelli D, Paolucci S. Prognostic factors in multidisciplinary rehabilitation in multiple sclerosis: An outcome study. Multiple Sclerosis, 2005; 11:719–724. • Jonsson A, Ravnborg MH. Rehabilitation in multiple sclerosis. Phys Rehab Med 1998; 10(1):75–100. • Langdon DW, Thompson AJ. Multiple sclerosis: A preliminary study of selected variables affecting rehabilitation outcome. Multiple Sclerosis 1999; 5:94–100. • Patti F, Ciancio MR, Cacopardo M, Reggio E, Fiorilla T, Palermo F, Reggio A, Thompson AJ. Effects of a short outpatient rehabilitation treatment on disability of multiple sclerosis patients. A randomized controlled trial. J Neurol 2003; 250:861–866. • Romberg A, Virtanens A, Ruutiainen J et al. Effects of a six-month exercise programme on patients with multiple sclerosis. Neurol 2004; 63:2034–2038. Symptomatic Treatment, Neurorehabilitation, Service Delivery 115 • Solari A, Filippini G, Gasco P, et al. Physical rehabilitation has a positive effect on disability in multiple sclerosis patients. Neurology 1999; 52(1):57–62. • Storr L, Sorenson PS, Ravnborg M. The efficacy of multidisciplinary rehabilitation in stable multiple sclerosis patients. Multiple Sclerosis 2006;12:235-242.
Severe Disability • Gruenewald DA, Higginson IJ, Vivat B, Edmonds P, Burman RE. Quality of life measures for the palliative care of people severely affected by multiple sclerosis: A systematic review. Multiple Sclerosis 2004; 10:690–704. Models of Care • Carton H, Loos R, Pacolet J, Versieck K, Vlietink R. Utilisation and cost of professional care and assistance according to disability of patients with multiple sclerosis in Flanders (Belgium). J Neurol Neurosurg, Psychiatry 1998; 64:444–450. • Freeman JA, Thompson AJ. Community services in multiple sclerosis: Still a matter of chance. J Neurol, Neurosurg, Psychiatry 2000; 69:728–732. • Pozzilli C, Brunetti M, Amicosante AMV et al. Home based management in multiple sclerosis: Results of a randomized controlled trial. J Neurol, Neurosurg and Psychiatry 2002; 73:250–255.
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