Phantomschmerz: Aspekte der Neuroplastizität und Intervention

Zusammenfassung

Phantomschmerz ist eine häufige Folge von Amputationen. Bis zu 80 % aller Amputierten leiden darunter. Er muss von nicht-schmerzhaften Phantomempfindungen, Stumpfschmerzen und nicht-schmerzhaften Stumpfempfindungen unterschieden werden. In diesem Artikel wird ein umfassendes Modell des Phantomschmerzes präsentiert, welches die Rolle von Schmerz vor der Amputation betont und mit peripheren und zentralen Prozessen in Verbindung bringt. Insbesondere wird die Bedeutung kortikaler Reorganisation für das Entstehen von Phantomschmerz diskutiert. Schließlich werden neue Ansätze zur Prävention und Behandlung von Phantomschmerz vorgestellt, die durch ein Verhindern oder eine Rückbildung kortikaler Reorganisationsprozesse den Phantomschmerz positiv beeinflussen.

Abstract

Phantom-limb pain is a common sequel of amputation, occurring in up to 80 % of the amputee population. It must be differentiated from non-painful phantom phenomena, residual-limb pain, and non-painful residual-limb phenomena. A comprehensive model of phantom-limb pain is presented that assigns a major role to pain occurring before the amputation and to central as well as peripheral changes related to it. Special emphasis is put on the role of cortical reorganization in the development of phantom limb pain. Finally, new approaches to the prevention and treatment of phantom limb pain are presented that have a positive influence on phantom limb pain by preventing or reversing cortical reorganization.

Schlüsselwörter

Schmerzgedächtnis - Plastizität - Phantomschmerz - Reorganisation - chronischer Schmerz

Key words

Pain memory - plasticity - phantom pain - reorganization - chronic pain

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