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Komplexes regionales Schmerzsyndrom

Eine aktuelle Übersicht

Complex regional pain syndrome

A current review

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Zusammenfassung

Ein komplexes regionales Schmerzsyndrom („complex regional pain syndrome“, CRPS) kann sich als Komplikation nach Frakturen und Verletzungen der Extremitäten, aber auch nach Nervenläsionen oder Schädigungen des Zentralnervensystems entwickeln. Als klinisches Bild findet sich eine charakteristische Trias, die autonome, sensorische und motorische Störungen umfasst. Die Diagnose wird in erster Linie klinisch anhand der Budapest-Kriterien gestellt. Die Therapie ist multidisziplinär und individuell zu planen. Verschiedene Methoden der physikalischen Medizin und medikamentöse Verfahren sind integrale Bestandteile des Therapiekonzepts. Medikamentöse Therapien orientieren sich an der spezifischen Symptomkonstellation und umfassen Glukokortikoide, Radikalfänger, die Pharmakotherapie von neuropathischen Schmerzen und Substanzen, die in den Knochenstoffwechsel eingreifen. In ausgewählten Fällen können invasive Verfahren eingesetzt werden.

Abstract

Complex regional pain syndrome (CRPS) may develop following fractures, limb trauma, or lesions of the peripheral or central nervous system. The clinical picture consists of a triad of symptoms including autonomic, sensory, and motor dysfunction. Diagnosis is based on clinical signs and symptoms according to the Budapest criteria. Therapy is based on an individual and multidisciplinary approach. Distinct methods of physical therapy and pharmacological strategies are the mainstay of therapy. Pharmacotherapy is based on individual symptoms and includes steroids, free radical scavengers, treatment of neuropathic pain, and agents interfering with bone metabolism. In some cases invasive methods may be considered.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Maihöfner hat eine Beraterfunktion für die Firmen Astellas, Bionorica, Grünenthal sowie Mundipharma und hält Vorträge für die Firmen Allergan, Astellas, GlaxoSmithKline, Grünenthal, Janssen, Lilly und Pfizer. Der Beitrag enthält keine Studien an Menschen oder Tieren.

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  1. Klinik für Neurologie, Klinikum Fürth, Jakob-Henle-Str. 1, 90766, Fürth, Deutschland

    C. Maihöfner MHBA

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Maihöfner, C. Komplexes regionales Schmerzsyndrom. Schmerz 28, 319–338 (2014). https://doi.org/10.1007/s00482-014-1421-7

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