Notfälle bei Patienten mit neuromuskulären Erkrankungen

Zwar zählen neuromuskuläre Erkrankungen (NME) zu den selteneren, chronisch verlaufenden Erkrankungen in der Neurologie. Dennoch kann es bei dieser Erkrankungsgruppe zu schwerwiegenden und akut lebensbedrohlichen Komplikationen kommen, die eine rasche Diagnostik und Therapie benötigen. Dieser Artikel gibt einen Überblick über die häufigsten Notfälle bei relevanten NME und deren sinnvolle und pragmatische Therapie.

Kernaussagen

• Zu den akut lebensbedrohlichen Notfällen gehören bei neuromuskulären Erkrankungen (NME) im Wesentlichen

  • Schluckstörungen,

  • ventilatorisches Versagen und

  • Herzrhythmusstörungen.

• Schluckstörungen und das ventilatorische Versagen sind die Hauptursachen für eine erhöhte Mortalität bei neuromuskulären Erkrankungen.

• Die einzig sinnvolle Therapie des ventilatorischen Versagens liegt in der maschinellen Beatmung zur Entlastung der insuffizienten Atemmuskulatur.

• Nicht die Rhabdomyolyse selbst ist lebensbedrohlich, sondern die durch die Kreatinkinase-Überladung bedingte akute Niereninsuffizienz.

• Bei anästhesiologischen Verfahren sollten bei neuromuskulären Erkrankungen zur Verhinderung von Komplikationen triggerfreie Narkosen eingesetzt werden.

Schlüsselwörter

Ateminsuffizienz - Guillain-Barré-Syndrom (GBS) - Akute Parese - Rhabdomyolyse - Dysphagie - Myasthene Krise - AIDP

Publication History

Article published online:
03 June 2022

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