The introduction of long term disease-modifying treatments has by no means diminished the need for treatment of the acute attack and of the chronic symptoms of the disease. Because the manifestations of MS are varied and quite often pose different therapeutic challenges involving several specialties, a team approach has been advocated by some, whereas others prefer to personally handle most if not all aspects of the management. We favor the latter approach with referral to appropriate specialists when necessary. The advantage, in our view, is that it strengthens and personalizes the patient / caretaker relationship, provides more continuity in the therapeutic and management programs, and simplifies their monitoring. MS generally affects men and women at critical periods of their careers, and at the peak of their parenting lives. The psychological, social, professional and economic impact of being given the diagnosis of MS cannot be underestimated and, needless to say, imposes upon the physician the enormous responsibility of determining the accuracy of the diagnosis. It is our strongly held belief that the patient must be told his or her diagnosis, its basis, and as much of an explanation of its pathogenesis, prognosis and therapeutic options as they are able to understand. Information about the disease is widely available in popular magazines, from television programs, pharmaceutical companies’ advertisements, from the MS society and from the Internet, but it is not always reliable or authoritative. Patients should be encouraged to seek information about MS from their neurologists rather than from these other sources. A well informed patient is much more likely to be compliant and trustful, and such patient education significantly enhances the chances of success of the therapeutic program. The overriding consideration that must govern disease management in MS is the physician’s compassion. Too many neurologists are so busy that they fail to understand that it is essential to answer the patients’ questions and to inquire about their problems at work and at home, their relationship with spouse and family, their activities of daily living and their financial concerns. These are all as important parts of therapy as prescribing drugs for spasticity or urinary frequency. There are two aspects to the symptomatic treatment of MS: treating the acute episode and managing the chronic symptoms and neurologic deficits.