Skip to main content
SpringerLink
Log in

Neurological Symptoms

  • Reference work entry
  • First Online:
Book cover Textbook of Palliative Care

  • 202 Accesses

Abstract

Neurological disease is a major cause of disability and death across the world. There is increasing evidence that palliative care is effective in managing symptoms, maintaining and improving quality of life and helping patients and families cope with the deterioration. As the disease progression varies, both between diseases and for individuals. palliative care may be involved for varying periods of time, and may need to be involved episodically throughout the disease progression. Careful assessment of all the issues – physical, psychosocial and spiritual – will allow appropriate management and support for patients and families. Carer support is very important as families face all the issues of coping with a progressive disease. Recognition of the later stages of life is helpful in enabling patients, families and professionals to be able to prepare for the dying phase and manage all the issues appropriately.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 819.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,099.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agar MR, Lawlor PG, Quinn S, Draper B, Caplan GA, Rowett D, Sanderson C, et al. Efficacy of oral risperidone, haloperidol or placebo for symptoms of delirium among patient in palliative care. A randomised controlled trial. JAMA Int Med. 2017;177:34–42.

    Article  Google Scholar 

  • Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013;28:863–73. https://doi.org/10.1002/mds.25475.

    Article  PubMed  PubMed Central  Google Scholar 

  • Allen RP, Picchietti D, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003;4:101–19.

    Article  PubMed  Google Scholar 

  • Alves G, Forsaa EB, et al. Epidemiology of Parkinson’s disease. J Neurol. 2008;5:18–32.

    Article  Google Scholar 

  • Anderson JF, Augoustakis LV, et al. End-of-life decision-making in individuals with locked-in syndrome in the acute period after brainstem stroke. Intern Med J. 2010;40:61–5.

    Article  CAS  PubMed  Google Scholar 

  • Arenella C. Coma and persistent vegetative state: an exploration of terms. 2017. https://americanhospice.org/caregiving/coma-and-persistent-vegetative-state-an-exploration-of-terms/. Retrieved 20 Apr 2017.

  • Bade P. Improving communication when hearing loss is present #241. J Palliat Med. 2011;14(7):876–7. https://doi.org/10.1089/jpm.2011.9672. PMID: 21699426.

    Article  PubMed  Google Scholar 

  • Bagai A, Thavendiranathan P, et al. Does this patient have hearing impairment? JAMA. 2006;295:416–28.

    Article  CAS  PubMed  Google Scholar 

  • Balta O, Acar U, et al. Review of 306 evisceration surgeries performed between 2005 and 2013. Turk J Med Sci. 2016;46:463–7.

    Article  PubMed  Google Scholar 

  • Bauer G, Gerstenbrand F, et al. Varieties of the locked-in syndrome. J Neurol. 1979;221:77–91.

    Article  CAS  PubMed  Google Scholar 

  • Bennett M. The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001;92:147–57.

    Article  CAS  PubMed  Google Scholar 

  • Bisdorff A, Bosser AG, et al. The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Front Neurol. 2013;4(29). https://doi.org/10.3389/fneur.2013.00029. eCollection 2013.

  • Bouhassira D, Attal N, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114:29–36.

    Article  PubMed  Google Scholar 

  • Bryan Young, G. Stupor and coma in adults 2015; UpToDate.

    Google Scholar 

  • Buhmann C, Wrobel N, et al. Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy. J Neurol. 2017;264:758–69.

    Article  PubMed  Google Scholar 

  • Calsina-Berna A, Garcia-Gomez G, Gonzales-Baboteo J, Porta-Sales J. Threatment of chronic hiccups in cancer patients: a systematic review. J Pall Med. 2012;15:1142–50.

    Article  Google Scholar 

  • Carlos K, Prado GF, et al. Benzodiazepines for restless legs syndrome. Cochrane Database Syst Rev. 2017; 20(3). CD006939. https://doi.org/10.1002/14651858. CD006939.pub2. Review.PMID: 28319266.

  • Costigan M, Scholz J, et al. Neuropathic pain: a maladaptive response of the nervous system to damage. Ann Rev Neurosci. 2009;32:1–32.

    Article  CAS  PubMed  Google Scholar 

  • Cruccu G, Truini A. Tools for assessing neuropathic pain. PLoS Med. 2009;6:e1000045.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cuenca J, Glazebrook C, Kendall T, Hedderly T, Heyman I, et al. BMC Psychiatry. 2015;15:46. Published online 11 Mar 2015. https://doi.org/10.1186/s12888-015-0430-0.

  • Dal Bello-Haas V, Florence JM, Krivickas LS. Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database Syst Rev. 2013;2:CD005229.

    Google Scholar 

  • de Oliveira CO, Carvalho LB, et al. Opioids for restless legs syndrome. Cochrane Database Syst Rev. 2016; 29(6). CD006941. https://doi.org/10.1002/14651858. CD006941.pub2. Review.PMID:27355187.

  • Doty RL. Olfaction in Parkinson’s disease and related disorders. Neurobiol Dis. 2012;46:527–52.

    Article  PubMed  Google Scholar 

  • Doty RL, Deems DA, et al. Olfactory dysfunction in parkinsonism: a general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology. 1988;38:1237–44.

    Article  CAS  PubMed  Google Scholar 

  • Ducreux D, Attal N, et al. Mechanisms of central neuropathic pain: a combined psychophysical and fMRI study in syringomyelia. Brain. 2006;129:963–76.

    Article  PubMed  Google Scholar 

  • Dworkin RH, Backonja M, et al. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol. 2003;60:1524–34.

    Article  PubMed  Google Scholar 

  • Dworkin RH, O’Connor AB, et al. Pharmacologic management of neuropathic pain: evidence based recommendations. Pain. 2007;132:237–51.

    Article  CAS  PubMed  Google Scholar 

  • Dworkin RH, O’Connor AB, et al. Recommendations for the pharmacological Management of Neuropathic Pain: an overview and literature update. Mayo Clinic Proc. 2010;85(3 Suppl):S3–S14.

    Article  CAS  Google Scholar 

  • Feinberg L. Moving toward person-and family-centered care. Public Policy Aging Rep. 2014;24:97–101.

    Article  Google Scholar 

  • Fereshtehnejad SM, Shafieesabet M, et al. Restless legs syndrome in patients with Parkinson’s disease: a comparative study on prevalence, clinical characteristics, quality of life and nutritional status. Acta Neurol Scand. 2015;131:211–8.

    Article  PubMed  Google Scholar 

  • Finucane AM, Lugton J, Kennedy C, Spiller JA. The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psychooncolgy. 2017;26:291–300.

    Article  Google Scholar 

  • Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy. Definition proposed by the international league against epilepsy and the International Bureau for Epilepsy. Epilepsia. 2005;46:470–2.

    Article  PubMed  Google Scholar 

  • Galindo-Ferreiro A, Akaishi P, et al. Retrobulbar injections for blind painful eyes: a comparative study of Retrobulbar alcohol versus chlorpromazine. J Glaucoma. 2016;25:886–90.

    Article  PubMed  Google Scholar 

  • Haehner A, Boesveldt S, et al. Prevalence of smell loss in Parkinson’s disease—a multicenter study. Parkinsonism Relat Disord. 2009;15:490–4.

    Article  CAS  PubMed  Google Scholar 

  • Haehner A, Habersack A, et al. Early Parkinson’s disease patients on rasagiline present with better odor discrimination. J Neural Transm. 2015;122:1541–6.

    Article  CAS  PubMed  Google Scholar 

  • Haig AJ, Katz RT, et al. Mortality and complications of the locked-in syndrome. Arch Phys Med Rehabil. 1987;68:24–7.

    CAS  PubMed  Google Scholar 

  • Hain TC, Uddin M. Pharmacological treatment of vertigo. CNS Drugs. 2003;17:85–100.

    Article  CAS  PubMed  Google Scholar 

  • Hawkes C. Olfaction in neurodegenerative disorder. Adv Otorhinolaryngol. 2006;63:133–51.

    PubMed  Google Scholar 

  • Heckmann JG, Dinkel HP. Recovery of locked-in syndrome in central pontine myelinolysis. Am J Case Rep. 2013;14:219–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hogl B, Comella C. Therapeutic advances in restless legs syndrome (RLS). Mov Disord. 2015;30:1574–9.

    Article  PubMed  Google Scholar 

  • Hoogwout SJ, Paananen MV, et al. Musculoskeletal pain is associated with restless legs syndrome in young adults. BMC Musculoskelet Disord. 2015;16:015–0765.

    Article  Google Scholar 

  • Hosie A, Davidson PM, Agar M, Sanderson CR, Phillips J. Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: a systematic review. Pall Med. 2013;27:486–98.

    Article  Google Scholar 

  • Hosomi K, Morris S, Sakamoto T, Taguchi J, Maruo T, et al. Daily repetitive transcranial magnetic stimulation for post stroke upper limb paresis in the subacute period. J Stroke Cerebrovasc Dis. 2016;25:1655–64.

    Article  PubMed  Google Scholar 

  • Hummel T, Landis BN, et al. Smell and taste disorders. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04.

    PubMed  Google Scholar 

  • Jones S, Man WD, Gao W, Higginson IJ, Wilcock A, Maddocks M. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database Syst Rev. 2016;10:CD009419.

    PubMed  Google Scholar 

  • Kaub-Wittemer D, Steinbuchel N, et al. Quality of life and psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers. J Pain Symptom Manag. 2003;26:890–6.

    Article  Google Scholar 

  • Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurol Clin Pract. 2011;1:24–33.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kestelyn PG, Cunningham ET. HIV/AIDS and blindness. Bull World Health Organ. 2001;79:208–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Klockgether T. Ataxias. Parkinsonisms Relat Disord. 2007;13:S391–4.

    Article  Google Scholar 

  • Klockgether T. Sporadic ataxia with adult onset: classification and diagnostic criteria. Lancet Neurol. 2010;9:94–104.

    Article  CAS  PubMed  Google Scholar 

  • Kok VC, Lee P-H. Management of Hypoglycemia in nondiabetic palliative care patients: a prognosis-based approach. Palliat Care. 2016;10:1–5.

    PubMed  PubMed Central  Google Scholar 

  • Kompanje EJ. End-of-life decision-making in patients with locked-in syndrome. Intern Med J. 2010;40:607–8. https://doi.org/10.1111/j.1445-5994.2010.02227.x.

    Article  CAS  PubMed  Google Scholar 

  • Kuehlmeyer K, Racine E, et al. Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists. J Neurol. 2012;259:2076–89.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kumar A, Weber MH, Gokaslan Z, et al. Metastatic spinal cord compression and steroid treatment: A systematic review. Clin Spine Surg. 2017;30:156–163.

    Article  PubMed  Google Scholar 

  • Lahrmann H, Grisold W. Locked-in syndrome. In: Voltz R, Bernat JL, Borasio GD, et al., editors. Palliative care in neurology. Oxford: Oxford University Press; 2004. p. 135–42.

    Google Scholar 

  • Laureys S, Pellas F, et al. The locked-in syndrome: what is it like to be conscious but paralyzed and voiceless? Prog Brain Res. 2005;150:495–611.

    Article  PubMed  Google Scholar 

  • Levack P, Graham J, Collie D, et al. Scottish Cord Compression Study Group. Don’t wait for a sensory level–listen to the symptoms: a prospective audit of the delays in diagnosis of malignant cord compression. Clin Oncol (R Coll Radiol). 2002;14:472–80.

    Google Scholar 

  • Mackie S, Winkelman JW. Long-term treatment of restless legs syndrome (RLS): an approach to Management of Worsening Symptoms, loss of efficacy, and augmentation. CNS Drugs. 2015;29:351–7.

    Article  CAS  PubMed  Google Scholar 

  • Maddalena V, O’Shea F, et al. Palliative and end-of-life care in Newfoundland’s deaf community. J Palliat Care. 2012;28:105–12.

    Article  PubMed  PubMed Central  Google Scholar 

  • Malik FA, Hall EJ, Edmonds P. The palliative management of raised intra-cranial pressure. In: Booth S, Bruera E, editors. Primary and metastatic brain tumours. Oxford: Oxford University Press; 2004. p. 61–81.

    Chapter  Google Scholar 

  • Maschio M. Brain tumour-related epilepsy. Curr Neuropharmacol. 2012;10:124–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McCusker EA, Rudick RA, et al. Recovery from the ‘locked-in’ syndrome. Arch Neurol. 1982;39:145–7.

    Article  CAS  PubMed  Google Scholar 

  • McShane R, Nagy Z, et al. Anosmia in dementia is associated with Lewy bodies rather than Alzheimer’s pathology. J Neurol Neurosurg Psychiatry. 2001;70:739–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • MD Guidelines. 2017. Available from: http://www.mdguidelines.com/dizziness-and-giddiness.

  • Mercadante S, Porzio G, Valle A, Fusco F, Aielli F, Adile C, Casuccio A. Orphan symptoms in advance cancer patients followed at home. Support Care Cancer. 2013;21:3525–8.

    Article  PubMed  Google Scholar 

  • Mercadante S, Adile C, Ferrera P, Corttegiani A, Casuccio A. Delirium assessed by memorial assessment scale in advance cancer patients admitted to an acute palliative/supportive care unit. Curr Med Res Opin. 2017;33:1–16. https://doi.org/10.1080/03007995.2017.1315332.

    Article  Google Scholar 

  • National Institute for Health and Care Excellence (NICE). Metastatic spinal cord compression in adults: risk assessment, diagnosis and management. 2008. www.nice.org.uk/guidance/cg75.

  • National Institute for Health and Care Excellence. Motor neurone disease: assessment and management. NICE Guideline NG 42. NICE 2016. www.nice.org.uk/guidance/NG42

  • Neuhauser H, et al. Zolmitriptan for treatment of migrainous vertigo: a pilot randomized placebo controlled trial. Neurology. 2003;60:882–3.

    Article  CAS  PubMed  Google Scholar 

  • Nichols DA, Allen RP, et al. Restless legs syndrome symptoms in primary care: a prevalence study. Arch Inter Med. 2003;163:2323–9.

    Article  Google Scholar 

  • Nordin S, Paulsen JS, et al. Sensory- and memory-mediated olfactory dysfunction in Huntington’s disease. J Int Neuropsychol Soc. 1995;1:281–90.

    Article  CAS  PubMed  Google Scholar 

  • Ohayon MM, O’Hara R, et al. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012;16:283–95.

    Article  PubMed  Google Scholar 

  • Oliver D. The prevention and treatment of seizures in intra-cranial malignancy. In: Booth S, Bruera E, editors. Palliative care consultations: primary and metastatic brain tumours. Oxford: Oxford University Press; 2004. p. 49–59.

    Chapter  Google Scholar 

  • Pall HS. Involuntary movements. In: Williams AC, editor. Patient care in neurology. Oxford: Oxford University Press; 1999. p. 127–43.

    Google Scholar 

  • Panzer J, Dalmau J. Movement disorders in paraneoplastic and autoimmune disease. Curr Opin Neurol. 2011;24:346–53. https://doi.org/10.1097/WCO.0b013e328347b307.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pi J, Kang Y, Smith M, Earl M, Norigian Z, McBride A. A review in the treatment of oncologic emergencies. J Oncol Pharm Practice. 2016;22:625–38.

    Article  CAS  Google Scholar 

  • Ramjit AL, Sedig L, et al. The relationship between anosmia, constipation, and orthostasis and Parkinson’s disease duration: results of a pilot study. Int J Neurosci. 2010;120:67–70.

    Article  CAS  PubMed  Google Scholar 

  • Regard C, Reynolds J, Watson B, Matthews D, Gibson L, Clarke C. Understanding distress in people with severe communication difficulties: developing and assessing the disability distress assessment tool (DisDAT). J Intellect Disabil Res. 2007;51:277–92.

    Article  Google Scholar 

  • Rousseau MC, Pietra S, et al. Evaluation of quality of life in complete locked-in syndrome patients. J Palliat Med. 2013;16:1455–8.

    Article  PubMed  Google Scholar 

  • Rousseau MC, Baumstarck K, et al. Quality of life in patients with locked-in syndrome: Evolution over a 6-year period. Orphanet J Rare Dis. 2015;10:88.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saarto T, Wiffen PJ. Antidepressants for neuropathic pain: a Cochrane review. J Neurol Neurosurg Psychiatry. 2010;81(12):1372–3. https://doi.org/10.1136/jnnp.2008.144964. Epub 2010 Jun 11. Review.

    Article  Google Scholar 

  • Saita L, Polastri D, et al. Visual disturbances in advanced cancer patients: clinical observations. J Pain Symptom Manag. 1999;17:224–6.

    Article  CAS  Google Scholar 

  • Savage P, Sharkey R, Kua T, Schofield L, Ricahrdson D, et al. Malignant spinal cord compression: NICE guidance, improvements and challenges. Q J Med. 2014;107:277–82.

    Article  CAS  Google Scholar 

  • Schnakers C, Perrin F, et al. Detecting consciousness in a total locked-in syndrome: an active event-related paradigm. Neurocase. 2009;15:271–7.

    Article  PubMed  Google Scholar 

  • Scholz J, Mannion RJ, et al. A novel tool for the assessment of pain: validation in low back pain. PLoS Med. 2009;6:7.

    Article  Google Scholar 

  • Shprecher S, Kurlan R. The management of tics. Mov Disord. 2009;24:15–24. https://doi.org/10.1002/mds.22378.

    Article  PubMed  PubMed Central  Google Scholar 

  • Silver B, Grover KM, et al. Recovery in a patient with locked-in syndrome. Can J Neurol Sci. 2006;33:246–9.

    Article  PubMed  Google Scholar 

  • Smith HS, Busracamwongs A. Management of hiccups in the palliative care population. Am J Hosp Palliat Care. 2003;20:149–54.

    Article  PubMed  Google Scholar 

  • Smith AK, Jain N, et al. Hearing loss in palliative care. J Palliat Med. 2015;18:559–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Swartz R, Longwell P. Treatment of vertigo. Am Fam Physician. 2005;71:1115–22.

    PubMed  Google Scholar 

  • Thadani VM, Rimm DL, et al. Locked-in syndrome for 27 years following a viral illness: clinical and neurologic findings. Neurology. 1991;41:498–500.

    Article  CAS  PubMed  Google Scholar 

  • The Palliative Care Formulary. 2016. Available from: http://www.palliativedrugs.com/.

  • Tradounsky G. Seizures in palliative care. Can Fam Physician. 2013;59:951–5.

    PubMed  PubMed Central  Google Scholar 

  • Uecker FC, Olze H, et al. Longitudinal testing of olfactory and gustatory function in patients with multiple sclerosis. PLoS One. 2017;2(1):e0170492. https://doi.org/10.1371/journal.pone.0170492. eCollection 2017.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Walters AS, Winkelmann J, et al. Long-term follow-up on restless legs syndrome patients treated with opioids. Mov Disord. 2001;16:1105–9.

    Article  CAS  PubMed  Google Scholar 

  • Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc. 2003;4:9–15.

    Article  PubMed  Google Scholar 

  • Weinstein BE. Palliative care: defining the role of the audiologist. Hear J. 2015;68:23–4.

    Article  Google Scholar 

  • Wenning GK, Shephard B, et al. Olfactory function in atypical parkinsonian syndromes. Acta Neurol Scand. 1995;91:247–50.

    Article  CAS  PubMed  Google Scholar 

  • Wijdicks EF, Bamlet WR, et al. Validation of a new coma scale: The FOUR score. Ann Neurol. 2005;58:585–93.

    Article  PubMed  Google Scholar 

  • Woelk CJ. Managing hiccups. Can Fam Physcian. 2011;57:672–5.

    Google Scholar 

  • World Health Organization. Palliative care. 2002. www.who.int/cancer/palliative/definition/en/. Accessed 26 July 2015.

  • Yeh P, Walters AS, et al. Restless legs syndrome: a comprehensive overview on its epidemiology, risk factors, and treatment. Sleep Breath. 2012;16:987–1007.

    Article  PubMed  Google Scholar 

  • Yorston D. The role of the ophthalmologist in advanced disease. In: Dunn G, Johnson A, editors. Surgical palliative care; 2004. Oxford Scholarship Online.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tizard Centre, University of Kent, Canterbury, Kent, UK

    David Oliver

  2. Fondazione FARO, palliative care, Torino, Italy

    Simone Veronese

Authors
  1. David Oliver
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simone Veronese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Oliver .

Editor information

Editors and Affiliations

  1. School of Medicine,Palliative Care, HammondCare, The University of Sydney School of Medicine, Sydney, Australia

    Roderick Duncan MacLeod

  2. VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care and Department of Clinical Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Lieve Van den Block

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Oliver, D., Veronese, S. (2019). Neurological Symptoms. In: MacLeod, R., Van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-77740-5_23

Download citation

Publish with us

Policies and ethics

Search

Navigation