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Introduction to neurological disorders other than dementia Introduction to neurological disorders other than dementia
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Causes of death Causes of death
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Amyotrophic lateral sclerosis Amyotrophic lateral sclerosis
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Amyotrophic lateral sclerosis: a brief summary Amyotrophic lateral sclerosis: a brief summary
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Approaches to treatment Approaches to treatment
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Symptoms and treatment options Symptoms and treatment options
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Respiratory insufficiency Respiratory insufficiency
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Mucous congestion of the airways Mucous congestion of the airways
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Malnutrition Malnutrition
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Sialorrhoea Sialorrhoea
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Spasticity and muscle cramps Spasticity and muscle cramps
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Insomnia and fatigue Insomnia and fatigue
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Pseudobulbar affect Pseudobulbar affect
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Depression, suicidality, and death Depression, suicidality, and death
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Patient management Patient management
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Parkinsonian syndromes Parkinsonian syndromes
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Parkinson’s disease and related conditions Parkinson’s disease and related conditions
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Atypical parkinsonian disorders Atypical parkinsonian disorders
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Symptomatic management of atypical parkinsonian disorders Symptomatic management of atypical parkinsonian disorders
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Motor function Motor function
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Dysautonomia Dysautonomia
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Dysarthria and dysphagia Dysarthria and dysphagia
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Psychiatric symptoms Psychiatric symptoms
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Sleep disorders Sleep disorders
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The last phase The last phase
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Multiple sclerosis Multiple sclerosis
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Medication at the end of life Medication at the end of life
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References References
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Online references Online references
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15.5 Neurological disorders other than dementia
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Published:March 2015
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Abstract
The significance of a palliative care approach for patients with neurological disorders other than dementia is increasingly recognized. Whereas the care for these patients, for example, those with amyotrophic lateral sclerosis (ALS) or motor neuron disease, had been incorporated in the initial concept by Dame Cicely Saunders, recent scientific evidence supports this position. The need for palliative care in these patients is underpinned by their frequent wish for hastening death. This chapter describes palliative care approaches for a number of neurological disorders other than dementia. For ALS, palliative care management including specific issues such as respiratory insufficiency or malnutrition are fairly well established. Also, in parkinsonian syndromes, a lot of palliative care needs can be recognized and managed effectively. For patients with multiple sclerosis, the first randomized controlled trial showed clearly positive effects on symptoms as well as usage of health-care resources. The chapter also summarizes the drug use for specific symptom management, accounting for alternative application routes.
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