Zusammenfassung
Dissoziative Anfälle sind plötzlich auftretende und zeitlich begrenzte Störungen der Wahrnehmung und der Bewegungskontrolle, die äußerlich anderen neurologischen Paroxysmen wie epileptischen Anfällen oder Synkopen ähneln können. Allerdings liegt dissoziativen Anfällen weder eine neuronale Hypersynchronisation noch eine zerebrale Minderdurchblutung zugrunde, sondern eine komplexe neurokognitive Dysfunktion. Sie machen etwa 10 % aller „Krampfanfälle“ im Rettungsdienst aus und sind eine häufige Diagnose an Epilepsie-Zentren. Die Diagnose erfolgt anhand der charakteristischen Semiologie. Entsprechend dem klinischen Bild kann eine weiterführende Diagnostik mittels Video-EEG und Kipptisch-Untersuchung zur sicheren Abgrenzung von anderen neurologischen Paroxysmen notwendig sein. Die Ätiologie ist multifaktoriell. Moderne Krankheitsmodelle sehen in den Anfällen eine maladaptive Verhaltensschablone, die unter bestimmten Umständen (z. B. Belastung oder Suggestion) reflexartig ausgeführt wird. Psychotherapie gilt als Mittel der Wahl.
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Popkirov, S. (2020). Dissoziative Anfälle. In: Funktionelle neurologische Störungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61272-9_5
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