title: [Multimorbidity of neurological patients in palliative care units].
abstract: BACKGROUND
  Multimorbidity in patients with neurological diseases needs enhanced attention. Especially the treatment with medication for comorbidities should be regularly evaluated and adapted to the current condition of the patient.
  
  
  OBJECTIVE
  The problem of how to deal with multimorbidity of neurological patients on palliative care units is discussed.
  
  
  METHODS
  This article gives a retrospective review of data and presentation of own results together with a discussion on basic knowledge and expert recommendations.
  
  
  RESULTS
  Multimorbidity of patients with neurological diseases depends on the underlying disease and age. Multimorbidity is often associated with polypharmacy which should be critically evaluated during palliative care treatment. Long-term pharmacological treatment often needs to be terminated as the side effects outweigh the benefits. Our own data show that patients leaving the palliative care unit often have a reduced amount of drugs compared to those who have died. Multimorbidity at the end of life includes dementia, delirium and epileptic seizures as well as symptoms associated with tube feeding. Artificial nutrition should be regarded as a form of pharmacological treatment and its usefulness at the end of life carefully evaluated.
authors.affiliation: Klinik für Palliativmedizin und Neurologische Klinik, Klinikum Großhadernder LMU München, Marchinoninistr. 14, 81377, München, Deutschland, stefan.lorenzl@med.uni-muenchen.de.
authors.forename: S
authors.initials: S
authors.lastname: Lorenzl
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D004185:Disability Evaluation; D004347:Drug Interactions; D004750:Enteral Nutrition / Q000639:trends; D005858:Germany; D006801:Humans; D008134:Long-Term Care / Q000639:trends; D018447:Medical Futility; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D010166:Palliative Care; D019338:Polypharmacy; D011788:Quality of Life; D012189:Retrospective Studies