Neurol. praxi. 2020;21(2):97-99 | DOI: 10.36290/neu.2020.055
Nutrition dilemma: gastrostomy in a patient with Parkinson's disease. Collaboration of a palliative care specialist and a neurologist
- 1 Centrum podpůrné a paliativní péče, Klinika anesteziologie a intenzivní medicíny, 1. LF UK a VFN, Praha
- 2 Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN, Praha
Advanced Parkinson's disease (PD) is characterized by many complications: motor fluctuations and dyskinesias, but also non-motor symptoms. From the palliative point of view the concept of advanced PD refers to a situation when non-motor symptoms surpass motor symptoms in severity and movement disability does not respond any more to therapeutic interventions. We present an illustrative case report demonstrating the utility and benefit of interdisciplinary collaboration of neurologists and palliative care specialists in a chronic disease with irreversible progression. The palliative care specialist's opinion is helpful in current medical decision making and definition of real goals of treatment based on the patient's or his relative's preferences, and adequate management of complications. The neurologist may contribute to better orientation in the clinical situation, the progression rate of neurodegeneration and in prediction of complications.
Keywords: Parkinson's disease, neurodegenerative disorder, palliative care, goals of treatment, family conference.
Published: June 2, 2020 Show citation
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References
- Burgos R, Bretón I, Cereda E, Desport JC, Dziewas R, Genton L, Gomes F, Jésus P, Leischker A, Muscaritoli M, Poulia KA, Preiser JC, Van der Marck M, Wirth R, Singer P, Bischoff SC. ESPEN guideline clinical nutrition in neurology Clin Nutr 2018; 37: 354-396. doi: 10.1016/j.clnu.2017.09.003.
Go to original source... 
Go to PubMed... - Kluger BM, Miyasaki J, Katz M, Galifianakis N, Hall K, Pantilat S, Khan R, Friedman C, Cernik W, Goto Y, Long J, Fairclough D, Sillau S, Kutner JS. Comparison of Integrated Outpatient Palliative Care With Standard Care in Patients With Parkinson Disease and Related Disorders: A Randomized Clinical Trial. JAMA Neurol. Published online Februar 10, 2020. doi: 10.1001/jamaneurol. 2019. 4992. Go to original source...
- Nejm MB, Andersen ML, Tufik S, Finsterer J, Scorza FA. Sudden death in Parkinson's disease: Unjustifiably forgotten. Parkinsonism Relat Disord 2019; 58: 88-89. doi: 10.1016/j.parkreldis.2018.08.012. Go to original source... Go to PubMed...
- Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, Schrag AE, Lang AE. Parkinson disease. Nat Rev Dis Primers 2017; 3: 17013. doi: 10.1038/nrdp.2017.13. Go to original source... Go to PubMed...
- Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, Vandewoude M, Wirth R, Schneider SM. ESPEN guidelines on nutrition in dementia. Clin Nutr 2015; 34: 1052-73. doi: 10.1016/j.clnu.2015.09.004. Go to original source... Go to PubMed...