Palliative and end-of-Iife care in advanced Parkinson's disease and multiple sclerosis

摘要

Patients with advanced Parkinson's disease (PD) and multiple sclerosis (MS) can present with challenging clinical problems when admitted to acute hospitals. They are susceptible to life-threatening complications, most commonly sepsis, which arise against a backdrop of progressive decline in overall function. Both PD and MS may be complicated by cognitive impairment, swallowing or speech problems and refractory pain syndromes. Robust evidence supporting treatment decisions in advanced disease is lacking, but recent national guidelines recognise the importance of shifting goals towards a palliative approach as the disease becomes more advanced.