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Neues zur symptomatischen MS-Therapie: Teil 6 – kognitive Störungen und Rehabilitation

New aspects of symptomatic MS treatment: Part 6 – cognitive dysfunction and rehabilitation

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Zusammenfassung

Die symptomatische Behandlung der multiplen Sklerose (MS) hat heutzutage neben der Immuntherapie einen hohen Stellenwert im umfassenden Therapiekonzept dieser chronischen Erkrankung, trägt sie doch erheblich zu einer Verringerung von Beeinträchtigungen im Alltag, sozialen und beruflichen Leben sowie zur Verbesserung der Lebensqualität bei. Seit der letzten umfassenden Bestandsaufnahme 2004 in dieser Zeitschrift sowie den Leitlinien der Deutschen Gesellschaft für Neurologie (DGN)/Klinisches Kompetenznetz Multiple Sklerose (KKN-MS) zu Diagnose und Therapie der MS 2014 haben sich Neuerungen und Ergänzungen in den Bereichen Mobilität, Blasenfunktion, Sexualfunktionen, Augen, Fatigue, Kognition und Rehabilitation ergeben. Diese sowie weitere Aspekte (Messmethoden des jeweiligen Symptoms, Therapieziele, Gesamtbehandlungsplan) werden in mehreren Einzelbeiträgen vorgestellt. In diesem Abschnitt wird auf die kognitiven Störungen und die wachsende Bedeutung der Rehabilitation eingegangen.

Abstract

The symptomatic treatment of multiple sclerosis (MS) is nowadays of similar importance as immunotherapy within a comprehensive treatment concept of this chronic disease. It makes a considerable contribution to the reduction of disabilities in activities of daily living as well as social and occupational life. Moreover, symptomatic treatment is of great importance for amelioration of the quality of life. Since our last survey of symptomatic MS treatment in 2004 and publication of the guidelines of the German Neurological Society and the Clinical Competence Network Multiple Sclerosis (“Klinisches Kompetenznetz Multiple Sklerose”, KKN-MS) in 2014 several developments within the topics of mobility, bladder and sexual function, vision, fatigue, cognition and rehabilitation have taken place. These new findings together with further aspects of disease measurement methods and overall treatment strategies of the respective symptoms, as well as treatment goals are introduced in several individual contributions. In this article the symptoms of cognitive disorders and the growing impact of rehabilitation are discussed.

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Danksagung

Wir bedanken uns bei der Firma Almirall Hermal für finanzielle Hilfe bei der technischen Erstellung des Manuskripts, ebenso bei Frau Dr. U. Essner sowie Frau Dr. P. Hundehege und Frau L. Forster (Neurologische Universitätsklinik Münster) für ihre Hilfe bei der Erstellung des Manuskripts.

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Authors and Affiliations

  1. Praxisgemeinschaft für Neurologie, Psychiatrie, Psychotherapie, Günzstr. 1, 93059, Regensburg, Deutschland

    T. Henze

  2. Department für Neurologie und Institut für Translationale Neurologie, Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Münster, Deutschland

    S. G. Meuth

  3. Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gemeinnützige GmbH, Berg, Deutschland

    W. Feneberg & M. Starck

  4. Neurologisches Rehabilitationszentrum Quellenhof, Bad Wildbad, Deutschland

    P. Flachenecker

  5. Bocholt, Deutschland

    D. Seidel

  6. Praxis für Neurologie, München, Deutschland

    H. Albrecht

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  1. T. Henze
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  2. W. Feneberg
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  3. P. Flachenecker
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  4. D. Seidel
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  5. H. Albrecht
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  6. M. Starck
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  7. S. G. Meuth
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Correspondence to T. Henze.

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Interessenkonflikt

T. Henze erhielt Vortragshonorare und Aufwandsentschädigungen für Advisory Boards von Almirall, Coloplast, Genzyme, Novartis, Sanofi. W. Feneberg erhielt Vortragshonorare, Aufwandsentschädigungen für Advisory Boards bzw. Unterstützung bei Fortbildungen von Almirall, Bayer, Biogen Idec, Coloplast, Genzyme, Ipsen, Merz, Novartis, Sanofi-Aventis P. Flachenecker hat Honorare für Vorträge und Beratungstätigkeiten von den Firmen Almirall, Bayer, Biogen Idec, Genzyme, Novartis, Merck Serono, Roche und Teva erhalten und an industriegesponsorten Studien von Biogen Idec und Novartis teilgenommen. H. Albrecht hat Zahlungen für Reisekosten und/oder Fortbildungsveranstaltungen und/oder Studien erhalten von Almirall, Bayer Healthcare, Biogen Idec, Genzyme-Sanofi, Merck Serono, Teva. S.G. Meuth erhielt Vortragshonorare, Aufwandsentschädigungen für Advisory Boards bzw. Unterstützung bei Fortbildungen und/oder Projektförderung von Bayer, Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi-Aventis und Teva. D. Seidel und M. Starck geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Weitere Beiträge dieser Beitragsserie, die ebenfalls in Der Nervenarzt publiziert wurden, befassen sich mit den Themen Einleitung und methodisches Vorgehen sowie Ataxie und Tremor (https://doi.org/10.1007/s00115-017-0438-4), Gangstörung und Spastik (https://doi.org/10.1007/s00115-017-0439-3), Blasenfunktionsstörungen (https://doi.org/10.1007/s00115-017-0440-x), Störungen der Sexualfunktion und der Augenbewegungen (https://doi.org/10.1007/s00115-017-0441-9) sowie Fatigue (https://doi.org/10.1007/s00115-017-0442-8).

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Henze, T., Feneberg, W., Flachenecker, P. et al. Neues zur symptomatischen MS-Therapie: Teil 6 – kognitive Störungen und Rehabilitation. Nervenarzt 89, 453–459 (2018). https://doi.org/10.1007/s00115-017-0443-7

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