Approximately 400,000 Americans have
multiple sclerosis. Worldwide,
multiple sclerosis affects 2.5 million individuals.
Multiple sclerosis affects two to three times as many women as men. The adverse effects of
hyperthermia in patients with
multiple sclerosis have been known since 1890. While most patients with
multiple sclerosis experience reversible worsening of their
neurologic deficits, some patients experience irreversible
neurologic deficits. In fact, heat-induced fatalities have been encountered in
multiple sclerosis patients subjected to
hyperthermia.
Hyperthermia can be caused through sun exposure, exercise, and
infection. During the last 50 years, numerous strategies have evolved to reduce
hyperthermia in individuals with
multiple sclerosis, such as photoprotective clothing, sunglasses,
sunscreens,
hydrotherapy, and prevention of
urinary tract infections.
Hydrotherapy has become an essential component of rehabilitation for
multiple sclerosis patients in hospitals throughout the world. On the basis of this positive hospital experience,
hydrotherapy has been expanded through the use of compact aquatic exercise pools at home along with personal cooling devices that promote local and systemic
hypothermia in
multiple sclerosis patients. The
Multiple Sclerosis Association of America and NASA have played leadership roles in developing and recommending technology that will prevent
hyperthermia in
multiple sclerosis patients and should be consulted for new technological advances that will benefit the
multiple sclerosis patient. In addition, products recommended for photoprotection by The
Skin Cancer Foundation may also be helpful to the
multiple sclerosis patient's defense against
hyperthermia.
Infections in the urinary tract, especially detrusor-external sphincter
dyssynergia, are initially managed conservatively with intermittent self-catheterization and pharmacologic
therapy. In those cases, refractory to
conservative therapy, transurethral external
sphincterotomy followed by
condom catheter drainage is recommended. However, if external urethral
sphincterotomy fails to reduce residual urine and detrusor pressure,
urinary diversion or bladder reconstruction may be necessary.