Langzeitbehandlung von Parkinsonpatienten mit Tiefer Hirnstimulation

Zusammenfassung

Seit mehr als 15 Jahren wird die Tiefe Hirnstimulation des Nucleus subthalamicus sowie des Globus pallidus internus zur Behandlung der fortgeschrittenen Parkinsonkrankheit eingesetzt. Die Zahl der Patienten mit langjähriger Behandlung steigt stetig. In der vorliegenden Übersichtsarbeit wird auf Besonderheiten der Langzeitbehandlung dieser Patienten eingegangen. Diese schließt Unterschiede der verschiedenen Stimulationssysteme, den Umfang von Kontrolluntersuchungen, Einschränkungen für medizinische Diagnostik und Therapien sowie das Vorgehen bei Befundverschlechterungen ein. Nach derzeitiger Datenlage ist davon auszugehen, dass die Krankheitsprogression durch die Tiefe Hirnstimulation nicht verhindert wird. Eine symptomatische Wirkung bleibt aber langfristig erhalten, sodass Therapieabbrüche die Ausnahme sind.

Abstract

For more than 15 years deep brain stimulation of the subthalamic nucleus and globus pallidus internus have become therapeutic options in advanced Parkinson’s disease. The number of patients with long-term treatment is increasing steadily. This review focuses on issues of the long-term care of these Parkinson’s patients, including differences of the available deep brain stimulation systems, recommendations for follow-up examinations, implications for medical diagnostics and therapies and an algorithm for symptom deterioration. Today, there is no profound evidence that deep brain stimulation prevents disease progression. However, symptomatic relief from motor symptoms is maintained during long-term follow-up and interruption of the therapy remains an exception.

Schlüsselwörter

Tiefe Hirnstimulation - Parkinson - Nucleus subthalamicus - Globus pallidus internus - Nucleus ventralis intermedius

Keywords

deep brain stimulation - Parkinson - subthalamic nucleus - globus pallidus internus - ventral intermediate thalamic nucleus

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