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Fortschr Neurol Psychiatr 2014; 82(2): 104-115
DOI: 10.1055/s-0033-1356453
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© Georg Thieme Verlag KG Stuttgart · New York

Das komplexe regionale Schmerzsyndrom

The Complex Regional Pain Syndrome
C. Sommer
1   Neurologische Klinik, Universitätsklinik Würzburg
,
F. Birklein
2   Klinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
› Author Affiliations
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Publication History

Publication Date:
11 February 2014 (online)

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Lernziele

Nach Lektüre des Artikels sollen Kenntnisse über Definition, Pathophysiologie und Therapie des CRPS vorhanden sein.

Das komplexe regionale Schmerzsyndrom (CRPS) ist definiert als ein posttraumatisches Schmerzsyndrom einer Extremität, bei dem die Schmerzen im Vergleich zum erwarteten Heilungsverlauf unangemessen stark ausgeprägt sind; die Symptome gehen über die Traumastelle hinaus und beschränken sich nicht auf das Innervationsgebiet einzelner peripherer Nerven oder Nervenwurzeln. Die Inzidenz liegt bei 5/100 000 oder bei 1 – 2 % aller Frakturen.

Eine frühzeitige Therapie kann die Ausbildung eines chronischen CRPS, das bis zur Gebrauchsunfähigkeit der betroffenen Extremität führen kann, verhindern. Die pathophysiologisch orientierte Therapie besteht in frühzeitiger Gabe von Kortikosteroiden und Bisphosphonaten. Ergänzend wird eine symptomatische Schmerztherapie eingesetzt. Unerlässlich, in akuten und auch chronischen Stadien, ist die spezielle CRPS-Physiotherapie, die auch verhaltenstherapeutische Elemente enthält.

 

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