Pumpentherapien für fluktuierende Patienten mit Morbus Parkinson

Zusammenfassung

Behandlungsmöglichkeiten des Morbus Parkinson haben sich in jüngerer Vergangenheit wesentlich erweitert, insbesondere für Patienten, die unter komplexen Fluktuationen ihres Bewegungszustands leiden. Sind wechselnde hypo- und dyskinetische Phasen mit konventionellen medikamentösen Strategien nicht zu kontrollieren, können heutzutage Pumpen zur kontinuierlichen Applikation von Apomorphin oder Levodopa eingesetzt werden. Obgleich diese Eskala­tionstherapien wie auch die Tiefenhirnstimulation prinzipiell das gleiche Behandlungsproblem adressieren, richten sich die einzelnen Methoden an zumindest teilweise unterschiedliche Patientengruppen. Der folgende Überblick stellt die wichtigsten Eigenschaften der verschiedenen Pumpentherapien und Kriterien für deren Einsatz dar.

Abstract

Treatment options for Parkinson’s disease (PD) have greatly increased during the last decades, mostly for patients with severe motor fluctuations. Next to deep brain stimulation (DBS), different pump systems for the continuous infusion of apomorphine and levodopa can provide decisive benefits, if optimised conventional drug therapy proceeds along with oscillations of the motor condition. Although drug pumps and DBS are principally indicated for similar long-term treatment problems in PD, these escalation therapies address at least partially distinct patient profiles. In the following survey the most relevant properties and application criteria of apomorphine and levodopa pump therapies are described.

Schlüsselwörter

Morbus Parkinson - kontinuierliche dopaminerge Stimulation - Pumpentherapien

Keywords

Parkinson’s disease - continuous dopaminergic stimulation - pump therapies

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