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Diepe hersenstimulatie voor tardieve dyskinesie en dystonie

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Handboek diepe hersenstimulatie bij neurologische en psychiatrische aandoeningen

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Samenvatting

Tardieve dyskinesie of dystonie (TD) is een veelvoorkomende bijwerking van dopaminereceptorblokkerende medicatie zoals antipsychotica en anti-emetica. De medicamenteuze behandeling van TD bestaat, waar mogelijk, uit staken van het veroorzakende middel of overstappen op clozapine wanneer antipsychotica nodig blijven. Als andere medicamenteuze opties geen effect hebben, kan diepe hersenstimulatie (‘deep brain stimulation’, DBS) van de globus pallidus internus overwogen worden. De effectiviteit van DBS bij TD lijkt vergelijkbaar met die bij primaire dystonie, met symptomatische verbetering van 60 tot 70 %. Er zijn geen aanwijzingen voor een nadelig effect van DBS op de psychiatrische toestand van patiënten, maar dit is gebaseerd op case reports en een aantal kleine en gebrekkig gerandomiseerde trials. DBS dient dus alleen overwogen te worden bij ernstige vormen van TD, waar de patiënt ernstig onder lijdt, of die fysiek invalideren en waarbij de patiënt niet of onvoldoende reageert op medicamenteuze behandeling of deze niet kan verdragen.

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Author information

Authors and Affiliations

  1. Aios GGZ centraal, Amersfoort, The Netherlands

    Charlie Mentzel

  2. School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

    Charlie Mentzel & Peter van Harten

  3. Innova GGz Centraal, Amersfoort, The Netherlands

    Peter van Harten

  4. Symfora Meander centrum voor Psychiatrie, Amersfoort, The Netherlands

    Peter van Harten

Authors
  1. Charlie Mentzel
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  2. Peter van Harten
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Editor information

Editors and Affiliations

  1. Maastricht University Medical Cente Department of Neurosurgery, Maastricht, The Netherlands

    Y. Temel

  2. Dept. Of Psychiatry, Maastricht Univeristy Medical Centre, Maastricht, The Netherlands

    A.F.G. Leentjens

  3. Afd. Neurologie, Amsterdam Medisch Centrum, Amsterdam, The Netherlands

    R.M.A. de Bie

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© 2016 Bohn Stafleu van Loghum

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Mentzel, C., van Harten, P. (2016). Diepe hersenstimulatie voor tardieve dyskinesie en dystonie. In: Temel, Y., Leentjens, A., de Bie, R. (eds) Handboek diepe hersenstimulatie bij neurologische en psychiatrische aandoeningen. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-368-0959-7_14

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  • DOI: https://doi.org/10.1007/978-90-368-0959-7_14

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  • Publisher Name: Bohn Stafleu van Loghum, Houten

  • Print ISBN: 978-90-368-0958-0

  • Online ISBN: 978-90-368-0959-7

  • eBook Packages: Dutch language eBook collection

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