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Neuropathische Schmerzen

Pathophysiologie, Diagnostik und Therapie
  • C. Sommer

Zusammenfassung

Neuropathische Schmerzen sind bedingt durch Läsionen im somatosensorischen System. Charakteristische, aber nicht exklusive Merkmale sind spontane Brennschmerzen, elektrisierende und einschießende Schmerzen, Hyperalgesie und Allodynie. Das Grundkonzept der Pathophysiologie neuropathischer Schmerzen besteht in der Kombination aus peripherer und zentraler Sensibilisierung. Die Kenntnisse über molekulare Mechanismen sind in den vergangenen Jahren exponentiell angewachsen. Problematisch sind die Gewichtung der einzelnen Mechanismen sowie die Erstellung eines integrierten Gesamtkonzepts. Fortschritte gab es auch in der Diagnostik, z. B. wurden die Methoden zur Erfassung von Funktionsstörungen der Nozizeptoren deutlich verbessert. Für die Therapie stehen heute weit mehr Optionen zur Verfügung als noch vor 15 Jahren. Unter den verfügbaren Medikamenten sind Antidepressiva, Antikonvulsiva, Opiate und Lokaltherapeutika. Daten aus kontrollierten Studien und Empfehlungen aus Leitlinien liegen vor.

Schlüsselwörter

Periphere Sensibilisierung Zentrale Sensibilisierung Transkutane elektrische Nervenstimulation Gabapentin Pregabalin 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • C. Sommer
    • 1
  1. 1.Neurologische KlinikUniversitätsklinikum WürzburgWürzburg

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