Diagnosis and conservative treatment of amyotrophic lateral sclerosis (als) in Prof. Christian Franke Neurology Clinic Munich

About the department

The Department of Neurology at Prof. Christian Franke Neurology Clinic Munich provides the full range of medical services in the area of its specialization. The healthcare facility provides comprehensive diagnostics and effective treatment of diseases of the nervous system. The department's team of doctors focuses on the treatment of patients with Parkinson's disease, multiple sclerosis, epilepsy, cerebrovascular diseases, chronic back pain, chronic headaches, dizziness, restless legs syndrome, and muscle diseases. The therapeutic process begins with a comprehensive neurological diagnosis, including clinical examination, doppler ultrasound, electroencephalography, electromyography, neurography, myography, registration of evoked potentials, laboratory blood tests, cerebrospinal fluid analysis, neuropsychological testing, etc. After studying the results of the preliminary diagnostics, the attending physician prepares an optimal treatment regimen for the patient, which is usually based on drug therapy. In many cases, oral medications, injections, and/or infusion therapy are supplemented with physiotherapy and therapeutic exercises (for example, for multiple sclerosis or chronic back pain). It is important for the department's medical team to provide individualized treatment aimed at achieving the best possible results and improving the quality of life.

The department is headed by Prof. Dr. med. Christian Franke, a competent neurologist with more than 35 years of successful clinical practice. During his work, the doctor has encountered clinical cases of varying complexity, and therefore has the necessary professional skills and expert knowledge to provide effective care to patients with neurological diseases.

The department regularly admits patients with multiple sclerosis, a chronic progressive disease of the nervous system in which foci of demyelination form in the brain and spinal cord. In most cases, multiple sclerosis has a wave-like course, with periods of remission alternating with relapses. The most common manifestations of this neurological condition include poor coordination, muscle weakness, urinary problems, sensory disturbances, fatigue, dizziness, vision problems, and tingling and numbness in the extremities. The diagnostic stage for multiple sclerosis includes magnetic resonance imaging, cerebrospinal fluid analysis, and registration of evoked potentials. The department's specialists then proceed to the elaboration of a treatment regimen. Multiple sclerosis is a chronic disease, so therapy is aimed at managing symptoms, achieving the longest possible remission, and reducing the frequency of exacerbations. To treat an exacerbation, the department's neurologists prescribe an intensive course of therapy with corticosteroids. Once remission is achieved, clinicians switch to disease-modifying therapy, which aims to regulate the immune response, reduce the frequency of exacerbations, and delay disability. During such a course of treatment, interferon beta-1b and interferon beta-1a are prescribed. Physiotherapeutic treatment is also performed to eliminate spasticity and muscle weakness.

The department's team of neurologists successfully treats muscle diseases such as myopathy, myotonia, muscular dystrophies, etc. This group of neurological diseases is characterized by a disorder in the structure or function of muscle fibers. Muscle diseases are transmitted genetically or develop as a result of autoimmune disorders. To make a diagnosis, the department's specialists conduct a clinical examination, followed by muscle strength, reflexes, and coordination testing. The next stage of the complex diagnosis involves electromyography and electroneurography to differentiate muscle disease from myelitis, myopathy, spinal cord tumors, and other neurological pathologies. Patients also undergo different blood tests. If clinically indicated, imaging studies (MRI and/or ultrasound scans) and a muscle biopsy may be performed. As for the treatment, the most commonly used therapy is symptomatic treatment with medications, physiotherapy (a series of physical exercises to maintain muscle strength and elasticity), classes with a speech therapist, and respiratory therapy.

The doctors at the medical facility are also highly skilled in providing medical care to patients with restless legs syndrome. The pathology is a neurological sensorimotor disorder characterized by an irresistible desire to move the lower extremities due to unpleasant sensations in them. Night rest becomes inadequate, and lack of sleep with restless legs syndrome may trigger the development of depression, anxiety disorders, and other serious health problems. The main sign of the pathology is discomfort in the feet and legs, such as burning, itching, tingling, pain, and heaviness in the legs. As a rule, discomfort appears while falling asleep and causes a persistent desire to move the legs. In some cases, discomfort appears during the daytime. Lack of sleep with restless legs syndrome negatively affects the immune system, causing the patient to often suffer from colds. In addition, the pathology leads to changes in heart rate and blood pressure, which increases the risk of developing pathologies of the cardiovascular system. The diagnostic protocol for suspected restless legs syndrome includes studying the patient's complaints, a neurological examination, electroneuromyography, and polysomnography. Blood and urine tests, CT or MRI scans of the brain, and Doppler ultrasound of the blood vessels of the lower extremities may be required to identify the cause of the pathology. Treatment tactics are elaborated depending on the form of restless legs syndrome because the condition can be primary or secondary. In the primary form of the disease, lifestyle modification (moderate physical activity, adherence to a sleep schedule, massage, warm foot bath before bed, etc.) and an individual treatment regimen with oral medications are indicated. If restless legs syndrome occurs against the background of another pathology, treatment aims to eliminate the underlying disease.

The department specializes in the diagnosis and treatment of the following neurological diseases:

• Inflammatory diseases of the nervous system: multiple sclerosis, neuroborreliosis, and others
• Muscle diseases
• Dizziness and balance problems
• Chronic headaches
• Chronic back pain
• Parkinson's disease
• Cerebrovascular diseases, including a stroke
• Epilepsy
• Restless legs syndrome
• Memory and concentration problems
• Brain tumors
• Peripheral nerve diseases
• Other neurological diseases

The department's range of diagnostic and therapeutic services includes the following:

• Diagnostic services
  • Ultrasound examinations: doppler ultrasound, continuous wave doppler ultrasound, duplex scanning of the blood vessels in the neck and brain
  • Electroencephalography
  • Electromyography
  • Neurography
  • Electroneuromyography
  • Registration of evoked potentials
  • Cerebrospinal fluid analysis
  • Blood tests
  • Neuropsychological testing
• Therapeutic services
  • Drug therapy: oral medications, injection therapy, and infusion therapy
  • Botulinum toxin therapy (Botox injections)
  • Physiotherapy
  • Therapeutic exercises
  • Occupational therapy
  • Speech therapy
  • Massage
• Other diagnostic and treatment methods