[Quality of life in patients with remitting-relapsing multiple sclerosis in Germany]. / Lebensqualität bei Patienten mit schubförmiger MS in Deutschland.

The concept of health-related quality of life (QoL) includes physical, psychological,and social aspects. This pertains to consequences of chronic diseases and their therapies beyond biological or pharmacological relations. A considerable amount of literature concerning QoL has been published with regard to neurological and non-neurological entities. This study summarizes data from a study in 717 persons with remitting-relapsing multiple sclerosis (MS). Of them,576 could be reevaluated longitudinally after 1 year of treatment with interferon-beta 1a (44 microg subcutaneous Rebif once weekly). Compared to populations of healthy controls or other patients, considerable reductions in the eight subscales and both physical and emotional sum scales of the German version of the short form of the Rand Health Questionnaire (SF-36) questionnaire were assessed. These reductions were even more pronounced in persons with gait impairments. Most SF-36 scales only modestly correlated to physical disability. This indicates that QoL as reported by patients does not depend solely on the physical symptoms of MS. Most findings remained stable for the study population as a whole during 1 year of therapy, while statistically significant improvements were found in clinical responders as defined in this study (relapse-free, physically stable, stable or improved in physician's judgement). Side effects of therapy were not reflected in lower QoL scale values. Implications of findings for future concepts in MS therapy are discussed.

Intravenous lisuride in the treatment of the neuroleptic malignant syndrome.

Four severe cases of the neuroleptic malignant syndrome (NMS) were successfully treated with intravenous infusion of the dopamine agonist lisuride in doses up to 0.25 mg per hour or 4.0 mg per day, respectively. Dramatic improvements of the clinical symptoms--in particular the extrapyramidal syndrome and state of consciousness-- could be observed in two cases. The pharmacological properties of intravenous lisuride seem to make it an alternative in the treatment of NMS, which merits further study.

[Neuroleptic malignant syndrome]. / Das neuroleptische maligne Syndrom.

The neuroleptic malignant syndrome (NMS) is presumably caused by neuroleptic blockade of dopamine receptors, mainly in the basal ganglia and hypothalamus. Symptoms include hyperthermia, muscular rigidity, and elevated serum creatine phosphokinase level, also autonomic dysfunction and, facultatively, impairment of consciousness. Clinical features, differential diagnosis and pathogenesis are discussed, as well as therapy with standard drugs as well as intravenous lisuride.