A review of the literature indicates that up to 80% of multiple sclerosis (MS) patients report worsening of symptoms with elevated body temperature; there are also anecdo tal reports of amelioration or improvement in some signs and symptoms of MS with low ering of core temperature. This paper reviews the possible physiological basis for tem perature effects in multiple sclerosis and discusses clinical trial design issues for objective evaluation of the therapeutic use of cooling in the symptomatic management of MS, cooling. garments, and core temperature measurement.
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