Multiple Sklerose – Diagnose und Behandlung neuropsychologischer Störungen

M. Paulig

doi:10.1055/s-0038-1630031

Nervenheilkunde, Table of Contents

Nervenheilkunde 2005; 24(10): 908-912
DOI: 10.1055/s-0038-1630031

Original Article

Schattauer GmbH

Multiple Sklerose – Diagnose und Behandlung neuropsychologischer Störungen

Multiple sclerosis – diagnosis and treatment of neuropsychological symptoms

Authors

M. Paulig

¹Neurologisches Krankenhaus München

Abstract

Zusammenfassung

Neuropsychologische Symptome sind in frühen Krankheitsstadien ein häufiges Phänomen bei Patienten mit einer Multiplen Sklerose und stellen eine Herausforderung für die Therapie dar. Die kognitiven Defizite sind oft klinisch subtil und sie korrelieren nicht mit der physischen Behinderung. Sie benötigen deshalb spezielle diagnostische Aufmerksamkeit einschließlich psychometrischer Testverfahren. Die Einschätzung der Symptome kann schwierig sein, da eine hohe Komorbidität mit Fatigue und Depression besteht, was zu wechselseitiger Beeinflussung der Phänomenologie führen kann. Neuropsychologische Rehabilitationsverfahren einschließlich computergestütztem Training sind empirisch hilfreich. Allerdings ist die Untermauerung durch Studiendaten gegenwärtig spärlich. Symptomorientierte pharmakologische und nicht-pharmakologische (z.B. Psychotherapie) Behandlungsmöglichkeiten bestehen für begleitende depressive Störungen und Fatigue. Die Behandlung mit Immunmodulatoren hat wahrscheinlich einen günstigen Einfluss auf den Verlauf kognitiver Defizite, wenn es auch hierzu nur wenige Daten gibt.

Summary

Neuropsychological symptoms are highly prevalent and a challenge for therapy in patients with multiple sclerosis, even in early stages of the disease. Cognitive deficits are often clinically subtle and they are not correlated with physical impairment. Therefore they need a separate diagnostic attention including psychometric testing. The assessment of syndromes may be difficult since there is a high comorbidity of cognitive disorders with fatigue and depression that reciprocally influence and modify the symptomatology. Neuropsychological rehabilitation including computer assisted cognitive training is empirically helpful however there is currently only a paucity of supporting data from studies. Symptomatic pharmacological and nonpharmacological (e.g. psychotherapy) options exist for the treatment of concomitant depression and fatigue. Immunomodulatory treatment is probably favourable for the course of neuropsychological deficits however this is only confirmed in a few studies.

Schlüsselwörter

Multiple Sklerose - Neuropsychologie - Kognition

Keywords

Multiple sclerosis - neuropsychology - cognition

Full Text

References

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