Multiple Sclerosis - the disease with 1,000 faces
Multiple Sclerosis (MS), also known as disseminated encephalomyelitis is one of the most common neurological conditions for people between 20 and 40 years of age. Women are affected more frequently by this autoimmune disease, which affects everyone in a different way.
The stages and courses are described as:
- the clinically isolated syndrome(CIS),
- the relapsing form ("relapsing -remitting", RRMS)
- the secondary progressive (SPMS) and
- the primary progressive onset form (PPMS)
The average age at the Pirawarth Clinic is 20 and older. "There are a few older people. They are usually already in a nursing home or home care as they no longer receive rehabilitation grants", says Dr. Schutzenberger-Sitta describing the situation.
The stay at the clinic
The approved health insurance therapy lasts four weeks. If a guest is making very good progress and is responsive to therapy, a two-week extension may also be approved by the health insurance authority.
As with the other departments at Pirawarth Clinic the General Practitioner checks the internal and neurological status directly on the day of arrival. The therapist assessment is carried out in the afternoon. Ocupational, physical, psychological and speech therapists together define the therapies which are suitable for each guest. Finally, the personal therapy plan is supplemented by the neurological medical specialists, such as when an ECG or an additional orthoptic examination is required.
"In cases of blind spot after retrobulbar neuritis the guest receives extra exploration and vision training", explains Dr. Schutzenberger-Sitta. "If there are problems with urination or incontinence, we offer additional pelvic floor exercises. There is also the possibility of an EEG examination if seizures have occurred. Ultrasound examinations are carried out if circulatory disorders, headaches and neurological signs are present".
The optimization of medication dosage is more complicated. Because mostly the senior consultant is responsible for the medication and the approval is made by the health insurance authority. In principle, we are committed to working closely with the resident doctors and MS centres to ensure optimal medical therapy in MS.
One measure that is not covered by the health insurance authority is botulinum toxin. The medication is injected into the spastic limbs. The effect is excellent, even if it only lasts three to six months and then must be re-administered. "Botulinum toxin reduces the extreme increase in muscle tightness due to the paralysis. The muscles that still work well, can then be targeted for use again," said Dr. Schutzenberger-Sitta. "If patients cannot afford private treatment, we refer them to the neurological outpatient clinic".
Dear coleagues, The entire assessment team at the Pirawarth Clinic is always open for questions and suggestions and for the exchange of information. We are at your disposal should you wish to discuss a special request regarding your patient.