Neurologie 2009

Was ist neu?

• Zerebrovaskuläre Erkrankungen:Telemedizinische Vorstellung bei Schlaganfall in überregionalen Versorgungszentren kann die Qualität der medizinischen Versorgung verbessern; systemische Thrombolyse bei ischämischen Schlaganfällen bis zu 4,5 h nach Symptombeginn wirksam; konsequente Hochdrucktherapie hilft, Schlaganfälle auch bei Hochbetagten zu verhindern, nicht aber die Entstehung einer Demenz.

• Neuro-degenerative Erkrankungen: Tiefe Hirnstimulation bei einem idiopathischem Parkinson-Syndrom der bestmöglichen Pharmakotherapie überlegen, Patienten müssen aber auf Zeichen einer Depressivität beobachtet werden; körperliche Übungsprogramme können möglicherweise den Verlauf einer dementiellen Erkrankung positiv beeinflussen.

• Kopfschmerz: CGRP-Antagonisten als neueSubstanzklasse in der Migränetherapie.

• Neuropathische Schmerzen: „Small-Fiber-Neuropathien” lassen sich nicht mit den klassischen Verfahren der Elektrophysiologie untersuchen, die Qualitative Sensorische Testung (QST) ermöglicht dabei eine standardisierte Untersuchung.

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