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All seven Medical Spheres ›Parkinson’s disease and multiple sclerosis are two different diseases of the nervous system that stay with people for many years. So far, neither can be cured. But much can be treated: with well-adjusted medication, therapy and exercise.
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Guide values based on the guidelines. Your personal treatment plan is agreed with you by the neurology team.
The conditions
In Parkinson’s disease, nerve cells in the midbrain that produce the chemical messenger dopamine are gradually lost. Dopamine is needed for smooth movement. Typical signs are movements that become slower and smaller, stiff muscles and a tremor at rest, often on one side of the body first. Steps and handwriting become smaller, the voice quieter. Years beforehand, a declining sense of smell, constipation or restless sleep in which dreams are acted out may already occur.
Multiple sclerosis is a chronic inflammatory disease of the brain and spinal cord. The immune system attacks the protective sheath around the nerve fibres, and areas of inflammation develop in many places. The symptoms vary accordingly: visual disturbances, tingling and numbness, paralysis, problems with balance and the bladder, or severe fatigue. Initially, it usually progresses in relapses that subside completely or partially; in some people, symptoms later worsen even without relapses. It often begins in young adulthood.
Neurologists diagnose Parkinson’s on the basis of the symptoms and a thorough examination; an MRI scan of the head helps rule out other causes. If MS is suspected, MRI shows typical lesions in the brain and spinal cord. Examination of the spinal fluid and measurement of evoked potentials – the conduction time of nerve pathways such as the optic nerve – support the diagnosis.
So far, neither disease can be cured. Treatment aims to relieve symptoms and preserve independence for as long as possible and, in MS, also to slow the course of the disease. In Parkinson’s, medication compensates for the lack of dopamine; doses and timings are adjusted again and again over the years, and in later stages medication pumps or deep brain stimulation at specialised centres may also be options. In MS, relapses are treated with high-dose anti-inflammatory medication. Long-term therapy that acts on the immune system aims to make relapses less frequent and slow progression.
The treatment
Medication needs the right dose at the right time. In Parkinson’s, it is adjusted over the years to fluctuations during the day; in MS, to the course of the disease and how well it is tolerated.
An MS relapse is treated as soon as possible, usually over three to five days. If it does not subside sufficiently, a repeat course of treatment or plasma exchange may follow.
Physiotherapy, occupational therapy and speech and language therapy train walking, balance, manual dexterity, speaking and swallowing. This aims to give confidence in everyday life and help prevent falls.
The path
Both conditions develop over years. Treatment is therefore reviewed and adjusted again and again.
Your GP or specialist refers you to the neurology outpatient clinic. Previous results, images from earlier examinations and your medication list should come with you.
A consultation, a neurological examination and tests of gait, fine motor skills and reflexes; depending on the question, an MRI scan, an examination of the spinal fluid or evoked potentials.
The diagnosis and goals are discussed: which medication, which therapies, which check-ups – and what helps in everyday life.
In the event of a severe relapse, a marked deterioration or to readjust medication, a hospital stay may be advisable.
Neurological rehabilitation combines physiotherapy, occupational therapy and speech therapy, for example after a relapse or when mobility declines.
Regular check-ups at a neurology practice or clinic keep treatment up to date.
Insurance
Statutory health insurance
Examinations, medication, any necessary hospital stay and prescribed therapies such as physiotherapy, occupational therapy and speech and language therapy are covered by German statutory health insurance. In Wertheim, this care is provided by the Bürgerspital, the hospital with a public healthcare mandate.
For the neurology outpatient clinic, a referral from your GP or specialist is usually all you need.
Private insurance or self-pay
Private health insurance and Beihilfe (the German civil service healthcare allowance) cover medically necessary treatment according to their terms.
In Wertheim, privately insured and self-pay patients can also use the Main-Tauber-Klinik, the private clinic in the same building.
Specialists
In Wertheim, Parkinson’s disease, multiple sclerosis and other movement disorders are treated by the Bürgerspital’s two neurologists. Both also work at the Main-Tauber-Klinik.
Locations
Each clinic shows on its own website how the treatment works there.
Germany
Neurology at the Bürgerspital, a hospital with a public healthcare mandate, with an outpatient clinic and inpatient treatment, plus a neurological rehabilitation clinic in the same building; the Main-Tauber-Klinik looks after privately insured and self-pay patients.
Frequently asked questions
No. More common is a tremor that mainly occurs when holding or reaching for something, such as what is known as essential tremor. Medication, an overactive thyroid or nervousness can also cause trembling. Typical of Parkinson’s is a tremor at rest, together with slowed movements.
Usually not. Only a small proportion of cases are due to altered genes, more often when the disease starts early. The neurology team can clarify whether genetic counselling makes sense.
By new symptoms, or symptoms that have become significantly worse, that last at least 24 hours and cannot be explained by fever, heat or an infection. If this happens, contact your neurology practice or clinic promptly. If symptoms come on suddenly, such as paralysis or a speech disorder, the same applies as for a stroke: call 112.
In the case of a severe relapse, when the effect of medication fluctuates strongly during the day, when falls, confusion or side effects occur, or when good adjustment cannot be achieved on an outpatient basis. In hospital, the effect of doses and timings can be observed over several days, and therapy is provided at the same time.
The guidelines recommend physiotherapy and exercise for both conditions. Regular physical activity can improve mobility, balance and stamina and help prevent falls. What suits you varies from person to person; physiotherapy shows you how to do it safely.
Usually care continues at a neurology practice, along with prescribed therapies such as physiotherapy or speech and language therapy. If more is needed, neurological rehabilitation may be an option. In the hospital building in Wertheim, the partner company Mediclin runs a neurological rehabilitation clinic.
Come along to appointments, note changes in everyday life and, with Parkinson’s, make sure medication is taken on time, including during a hospital stay. Support groups offer people with the condition and their relatives a chance to share experiences.
Consultation
Describe your request – the right clinic will get back to you.
Reviews
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Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanBisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in GermanIch fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
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Alster-Klinik Hamburg · Original in GermanÜber die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in GermanIch habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin eine sehr ängstliche Person. Bei Herrn Dr. Neis habe ich mich sofort wohlgefühlt. Behandlungsgespräche, Umgang, Freundlichkeit – es passt alles. Ich kann ihn ohne Bedenken und Einschränkung nur weiter empfehlen. Dankeschön Herr Dr. Neis für die tolle Arbeit.
CGCE Group · Original in GermanDr. Klarner ist sehr nett, hat mich sehr gut beraten und aufgeklärt. Ich hab mich gut aufgehoben gefühlt, vielen Dank!
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