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Intoxikationen als Ursachen von Bewusstseinsstörungen

Poisoning as cause of disturbance of consciousness

  • Leitthema
  • Published:
Intensivmedizin und Notfallmedizin

Zusammenfassung

Störungen des Bewusstseins sind das häufigste Leitsymptom bei Vergiftungen. Sie können sich als Verwirrung, Delir und Agitiertheit oder Somnolenz, Sopor und Koma zeigen. Viele Intoxikationen lösen zusätzlich zur Bewusstseinsstörung auch epileptiforme zerebrale Krampfanfälle aus. Daneben können muskuläre Symptome, v. a. ein vermehrter Muskeltonus oder auch ein Faszikulieren der Muskulatur, auf bestimmte Vergiftungen hinweisen. Es ist möglich, die Diagnose anhand dieser unterschiedlichen Symptomatik so einzugrenzen, dass ein gezielter Giftnachweis geführt werden kann. Bei schweren Vergiftungen ist die richtige Diagnose wegen einer gezielten Antidot- und Entgiftungstherapie bedeutend.

Abstract

In poisonings, the most common symptom is a disturbance of consciousness, which may appear as confusion, delirium, and agitation or as somnolence, stupor and coma. Many poisons also trigger convulsions. In addition, muscular symptoms, such as tremor, rigor, and fasciculation, can point to a specific poison. It is possible to narrow down the diagnosis by identifying the various symptoms, thus, allowing a specific laboratory test for the poison to be performed. In severe poisonings, correct diagnosis is mandatory in order to decide on a well-directed antidote therapy and the best method for detoxification

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  1. Toxikologische Abteilung, II. med. Klinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    T. Zilker

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Zilker, T. Intoxikationen als Ursachen von Bewusstseinsstörungen. Intensivmed 47, 101–108 (2010). https://doi.org/10.1007/s00390-009-0143-z

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