Update zur intensivierten Therapie des fortgeschrittenen idiopathischen Parkinson-Syndroms

Zusammenfassung

Das idiopathische Parkinson-Syndrom ist eine heterogene neurodegenerative Erkrankung. Während konservative pharmakologische Therapien in den anfänglichen Phasen der Krankheit gut wirken, können in fortgeschrittenen Stadien mit motorischen Komplikationen invasive Methoden wie die tiefe Hirnstimulation sowie die pumpengestützte Dauerinfusion von L-Dopa bzw. Apomorphin notwendig sein. Durch die in den letzten Jahrzehnten gewonnene Studienevidenz und klinische Erfahrung ist bei indikationsgerech tem Einsatz dieser Therapien auch bei einer fortgeschrittenen Parkinson-Krankheit ein er heblicher Gewinn an Lebensqualität für den Patienten möglich. Der Prozess zur Auswahl der individuell am besten geeigneten Therapie bleibt für den Patienten und den Neurologen komplex und schließt das Erkennen und Besprechen der Indikation auch außerhalb spezialisierter Zentren als notwendig ein. Hierzu bedarf es eines Überblicks über die einzelnen Therapieoptionen und ihrer Besonderheiten, der in den folgenden Abschnitten dargestellt wird.

Summary

Idiopathic Parkinson’s disease is a heterogeneous neurodegenerative disorder. While conservative therapies are very effective in the early stages of the disease, advanced stages of with motor complications demand more invasive methods like deep brain stimulation or pump-based infusion of L-DOPA and apomorphine. In the last decades, clinical experience and evidence on these therapies were established that considerably improve the patient’s quality of life even in advanced Parkinson’s disease. The choice for the right therapy remains complex for both the patient and the neurologist. However, the early identification and discussion of the indications with the patients and their caregivers are possible and needed outside of special izedcentres. Here we provide an up-to-date overview of the different therapy options and their individual characteristics.

Schlüsselwörter

Parkinson-Krankheit - fortgeschrittenes Stadi um - interventionelle Therapie

Keywords

Parkinson’s disease - advanced stages - interventional therapies - deep brain stimulation - DBS

^* Beide Autoren haben zu gleichen Teilen beige tragen.

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