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Komplexes regionales Schmerzsyndrom (CRPS)

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Praktische Schmerzmedizin

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Zusammenfassung

Das komplex-regionale Schmerzsyndrom (CRPS) ist durch Schmerz, sensorische, vegetative, motorische und trophische Störungen charakterisiert. Die Symptomatik ändert sich jedoch im Verlauf. Zu Beginn ist die Pathophysiologie durch die Aktivierung des Immunsystems dominiert. Danach entwickeln sich zentrale Reorganisations- und Lernvorgänge. Dadurch werden Bewegungsstörungen, vegetative und sensible Symptome und Körperschemastörungen generiert. Psychische Faktoren beeinflussen den Verlauf. Die Therapie muss der jeweiligen pathophysiologischen Veränderung angepasst sein: eine antientzündliche medikamentöse Therapie (Steroide, Bisphosphonate, DMSO-Creme) in akuten Stadien, gegen die Schmerzen die üblichen antineuropathischen Medikamente; i.v. Ketamin ist nebenwirkungsreich. Wichtige Therapiebestandteile sind weiter Physio- und Ergotherapie, z. T. mit verhaltenstherapeutischen Ansätzen, evtl. Psychotherapie, invasive Verfahren nur in Ausnahmefällen. Die Prognose bezüglich Funktion und Schmerz ist nicht generell schlecht.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland

    Frank Birklein

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  1. Frank Birklein
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Correspondence to Frank Birklein .

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Editors and Affiliations

  1. Klinik für Neurologie, Neurozentrum, Universitätsklinikum Kiel, Kiel, Germany

    Ralf Baron

  2. Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Germany

    Wolfgang Koppert

  3. Göttingen, Germany

    Michael Strumpf

  4. Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Germany

    Anne Willweber-Strumpf

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Birklein, F. (2019). Komplexes regionales Schmerzsyndrom (CRPS). In: Baron, R., Koppert, W., Strumpf, M., Willweber-Strumpf, A. (eds) Praktische Schmerzmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57487-4_43

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  • DOI: https://doi.org/10.1007/978-3-662-57487-4_43

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-57486-7

  • Online ISBN: 978-3-662-57487-4

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