Paliatívna medicína a liečba bolesti 1/2011

Palliative care in terminal states of motor neuron diseases (amyotrophic lateral sclerosis, progressive bulbar palsy, and progressive muscular atrophy)

Motor neuron disease (MND), most commonly presenting as amyotrophic lateral sclerosis (ALS) or progressive bulbar palsy (PBP) and progressive muscular atrophy (PMA), is a typical disease managed predominantly with palliative care. Over months to years, the condition progresses to a state of total dependence of the patient on both nursing care and artificial feeding or even mechanical ventilation. Thus, over time, the disease becomes extremely demanding for both the family and the attending physician. Therefore, treatment of a patient with MND requires knowledge of the practice of palliative medicine and palliative care. The paper deals with individual problems in palliative care in MND (weakness, immobility, depression, dysphagia, dysarthria, sialorrhoea, pain, spasticity, and respiratory difficulties) and their management options.

Keywords: palliative care, ALS, immobility, respiratory difficulties, dysphagia, PEG.