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Das komplexe regionale Schmerzsyndrom

Neue Erkenntnisse

  • Leitthema
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Zusammenfassung

Seit der Einführung der neuen Terminologie "komplexe regionale Schmerzsyndrome" (CRPS) anstelle der früheren Bezeichnungen der sympathischen Reflexdystrophie und der Kausalgie im Jahr 1995 gibt es viele neue Erkenntnisse zum Verständnis und zur Therapie der Erkrankung. Dieser Artikel soll einen Überblick über diese neuen Ergebnisse liefern durch Darstellung der klinischen Symptomatik, der Pathophysiologie sowie der diagnostischen und therapeutischen Möglichkeiten beim CRPS. Insbesondere soll auf die Rolle des sympathischen Nervensystems, des zentralen Nervensystems und von peripheren Entzündungsprozessen als zugrunde liegende Mechanismen der Krankheitsentstehung und -aufrechterhaltung eingegangen werden. Obwohl es bisher noch keinen diagnostischen Goldstandard gibt, erbringen eine sorgfältige klinische Untersuchung und apparative Zusatzverfahren wertvolle Informationen zur Diagnosestellung. Ein frühzeitiger Behandlungsbeginn mit interdisziplinärem Vorgehen ist entscheidend für eine optimale und erfolgreiche Therapie.

Abstract

Since the term "complex regional pain syndromes" (CRPS) was introduced based on a revised taxonomy for disorders previously called reflex sympathetic dystrophy and causalgia in 1995, much knowledge grew up on the understanding and therapy of the disease. This review gives an overview on the clinical characteristics, pathophysiology, diagnostic tools and therapeutic options in CRPS. It will especially focus on recent findings on the role of the sympathetic nervous system, the central nervous system and peripheral inflammatory processes as underlying mechanisms. Although there is no diagnostic gold standard, careful clinical evaluation and additional apparative test procedures are very helpful for the diagnosis. An early and interdisciplinary approach is the basis for an optimal and successful treatment.

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Danksagung

Unterstützt durch die Deutsche Forschungsgemeinschaft (DFG Ba 1921/1–2) und den BMBF Forschungsverbund "Neuropathischer Schmerz".

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Authors and Affiliations

  1. Klinik für Neurologie, Universitätsklinikum Kiel

    G. Wasner, J. Schattschneider, A. Binder & R. Baron

  2. Klinik für Anästhesie, Universitätsklinikum Kiel

    D. Siebrecht

  3. Abteilung für Schmerztherapie, BG-Klinik Bergmannsheil, Ruhr-Universität Bochum

    C. Maier

  4. Klinik für Neurologie, Universitätsklinikum Kiel, Niemannsweg 147, 24105, Kiel, Germany

    G. Wasner

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  1. G. Wasner
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Wasner, G., Schattschneider, J., Binder, A. et al. Das komplexe regionale Schmerzsyndrom. Anaesthesist 52, 883–895 (2003). https://doi.org/10.1007/s00101-003-0562-3

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