Download PDF
Nervenheilkunde 2017; 36(01/02): 67-70
DOI: 10.1055/s-0038-1635138
Muskelerkrankungen
Schattauer GmbH

Palliativtherapie neuromuskulärer Erkrankungen

Palliative care in neuromuscular disease
S. Lorenzl
1   Palliative Care, PMU Salzburg, Research Associate, LMU München, Neurologie, Krankenhaus Agatharied
,
P. Reilich
2   Friedrich Baur Institut, Neurologische Klinik und Poliklinik, Klinikum der Universität, LMU München
› Author Affiliations
Further Information

Publication History

eingegangen am: 25 September 2016

angenommen am: 06 October 2016

Publication Date:
03 February 2018 (online)

    Permissions and Reprints

Zusammenfassung

Die palliativmedizinischen und hospizlichen Versorgungsstrukturen und Angeboten wurden in den vergangenen Jahren in Deutschland stark ausgebaut. Dem klinisch tätigen Neurologen steht ein weites Spektrum an palliativmedizinischen Maßnahmen zur Verfügung. In dieser Arbeit wollen wir eine Übersicht über die Therapiemöglichkeiten der wichtigsten Symptome in der letzten Lebensphase am Beispiel von Patienten mit amyotropher Lateralsklerose (ALS) stellvertretend für Menschen mit neuromuskulären Erkrankungen geben und uns an den internationalen Empfehlungen der European Academy of Neurology sowie der nationalen S3-Leitlinie “Palliativmedizin” aus dem onkologischen Leitlinienprogramm orientieren.

Summary

The hospice and palliative care structures have been strongly expanded in Germany in recent years. In the patient care sector, neurologists have access to a wide spectrum of palliative care measures. In this article, we will give an overview of the therapeutic options of the most important symptoms in the last phase of life, using the example of patients with amyotrophic lateral sclerosis (ALS) as a substitute for the most neuromuscular diseases, by taking account to the international recommendations of the European Academy of Neurology as well as the national S3 guideline “Palliative Medicine” from the Oncological Guidelines Program.

Schlüsselwörter

Neuromuskuläre Erkrankungen - amyotrophe Lateralsklerose - palliative Therapie

Keywords

Neuromuscular disease - amyotrophic lateral sclerosis - palliative care
 

  • Literatur

  • 1 HOPE. HOPE-Bericht 2015. www.hopeclara.de/download_1/index.php
    Google Scholar
  • 2 S3-Leitlinie “Palliativmedizin” im Onkologischen Leitlinienprogramm. www.awmf.org/uploads/tx_szleitlinien/128–001OLl_S3_Palliativmedizin_2015–07.pdf.
    Google Scholar
  • 3 Bausewein C, Roller S, Voltz R. Leitfaden Palliative Care. 5. Auflage. München: Elsevier Verlag; 2015
    Google Scholar
  • 4 Oliver DJ, Borasio GD, Caraceni A, de Visser M, Grisold W, Lorenzl S, Veronese S, Voltz R. A consensus review on the development of palliative care for patients with chronic and progressive neurological disease. Eur J Neurol 2016; 23: 30-8.
    CrossrefPubMedGoogle Scholar
  • 5 Temel JS. et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363: 733-42.
    CrossrefPubMedGoogle Scholar
  • 6 Voltz R, Perrar KM. [How to react to a wish towards hastening death in palliative care?]. MMW Fortschr Med 2015; 157: 60-2.
    PubMedGoogle Scholar
  • 7 Lorenzl S, Nubling G, Perrar KM. et al. Palliative treatment of chronic neurologic disorders. Handb Clin Neurol 2013; 118: 133-139.
    PubMedGoogle Scholar
  • 8 Hensler M, Paul S, Abright C, Lorenzl S. [Progressive supranuclear palsy: living environment of the patients in Germany]. Nervenarzt 2011; 82 (02) 207-14.
    CrossrefPubMedGoogle Scholar
  • 9 Lorenzl S. [Multimorbidity of neurological patients in palliative care units]. Nervenarzt 2014; 85 (04) 409-16.
    CrossrefPubMedGoogle Scholar
  • 10 Grehl T. [Diagnostics and therapy for amyotrophic lateral sclerosis]. Fortschr Neurol Psychiatr 2013; 81 (10) 592-603.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Oliver DJ, Campbell C, O’brien T, Sloan R, Sykes N, Tallon C, Taylor-Horan J, Udoma M. Medication in the last days of life for motor neuron disease/amyotrophic lateral sclerosis. Amyotroph Lateral Scler 2010; 11 (06) 562-4.
    CrossrefPubMedGoogle Scholar
  • 12 Ostgathe C, Alt-Epping B, Golla H. et al. Noncancer patients in specialized palliative care in Germany: what are the problems?. Palliat Med 2011; 25 (02) 148-152.
    CrossrefPubMedGoogle Scholar
  • 13 Ostgathe C. et al. Differential palliative care issues in patients with primary and secondary brain tumours. Support Care Cancer 2010; 18 (09) 1157-63.
    CrossrefPubMedGoogle Scholar
  • 14 Van den Berg JP, Kalmijn S, Lindeman E. et al. Multidisciplinary ALS care improvesquality of life in patients with ALS. Neurology 2005; 65: 1264.
    CrossrefPubMedGoogle Scholar
  • 15 Strong M. The syndromes of frontotemporal dysfunction in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis 2008; 09: 323-338.
    CrossrefPubMedGoogle Scholar
  • 16 Mitsumoto H, Bromberg M, Johnston W. et al. Promoting excellence in end-of-life care in ALS. Amyotrophic Lateral Sclerosis 2005; 03: 145-154.
    Google Scholar
  • 17 Oliver D, Campbell C, O’Brien T, Sloan R, Sykes N, Tallon C, Taylor-Horan J. Medication in the last days of life of MND/ALS – A study from Specialist Palliative Care providers in the UK. ALS 2009; 10 (Suppl. 01) 13.
    Google Scholar
  • 18 Bourke SC, Tomlinson M, Willims TL, Bullock RE, Shaw PJ, Gibson GJ. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomized controlled trial. Neurology. The Lancet 2006; 05: 140-147.
    Google Scholar
  • 19 Alt-Epping B, Sitte T, Nauck F, Radbruch L. [Sedation in palliative medicine: Guidelines for the use of sedation in palliative care : European Association for Palliative Care (EAPC)]. Schmerz 2010; 24: 342-54.
    CrossrefPubMedGoogle Scholar