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Nichtdermatomgebundene somatosensorische Defizite bei chronischen Schmerzpatienten

Nondermatomal somatosensory deficits in chronic pain patients

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Zusammenfassung

Nichtdermatomgebundene somatosensorische Defizite (NDSD) sind bei chronischen Schmerzpatienten häufig und weisen auf Schmerzsensibilisierung und Schmerzzentralisierung hin. Klinisch findet sich in der Regel eine Berührungs- und Thermhypästhesie mit oftmals quadrantenartiger oder halbseitiger Ausbreitung. Bei der Mehrzahl der Patienten liegt anamnestisch ein somatisch-nozizeptives Auslöseereignis vor, das aber wie das komplexe regionale Schmerzsyndrom (CRPS) in keiner eindeutigen Relation zur nachfolgenden Schmerzstörung steht. Wie bei vielen chronischen Schmerzstörungen weisen auch Patienten mit NDSD oft eine überdurchschnittliche psychobiografische Stressbelastung auf. Die Ergebnisse der funktionellen Bildgebung weisen auf ein komplexes Muster zentralnervöser Dysregulationen hin.

Abstract

Nondermatomal somatosensory deficits (NDSDs) are frequently found in chronic pain patients and allude to pain sensitization and pain centralization. In the clinical examination NDSDs are as a rule accompanied by hyposensitivity to touch and heat perception often with a quadrantal or hemibody distribution. The majority of NDSD patients show a trigger episode with a somatic nociceptive trauma in the case history. These somatic findings, however, never fully explain the pain disorder, analogue to the complex regional pain syndrome (CRPS). Most patients with chronic pain disorders as well as those with NDSD often report an antecedent period of high psychobiological stress. The data from functional imaging reveal a complex pattern of a central nervous dysregulation.

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Authors and Affiliations

  1. Kompetenzbereich für Psychosomatische Medizin, Universitätsklinik für Allgemeine Innere Medizin, C.L. Lory-Haus, Inselspital Bern, 3010, Bern, Schweiz

    N. Egloff, F. Maecker & R. von Känel

  2. Zentrum für Schmerzmedizin, Schweizer Paraplegiker-Zentrum, Nottwil, Schweiz

    G. Landmann

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  1. N. Egloff
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  2. F. Maecker
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  3. G. Landmann
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  4. R. von Känel
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Correspondence to N. Egloff.

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Egloff, N., Maecker, F., Landmann, G. et al. Nichtdermatomgebundene somatosensorische Defizite bei chronischen Schmerzpatienten. Schmerz 25, 632–642 (2011). https://doi.org/10.1007/s00482-011-1109-1

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