Erworbene neuromuskuläre Überleitungsstörungen: Myasthenien und Lambert-Eaton Syndrom

Zusammenfassung

Die Gruppe der erworbenen myasthenen Syndrome gliedert sich in die postsynaptischen Myasthenien (MG) und das präsynaptische Lambert-Eaton-Syndrom (LEMS). Durch Verbesserung der Diagnostik (Rezeptor-Auto-Antikörper Diagnostik, Elektrophysiologie, Bildgebung, pharmakologische Testung) ist es möglich die spezifischen Erkrankungen nach pathophysiologischen Gesichtspunkten definierten Untergruppen zuzuordnen. Dies ermöglicht eine bessere und speziellere Therapie z. B. Indikation für die Thymektomie oder Vermeidung von Thymektomie, unterschiedliche Immunsuppression oder differenzierter Einsatz der Cholinesteraseinhibitoren im Rahmen der symptomatischen Therapie. Durch die gezieltere Diagnostik aufgrund des besseren pathophysiologischen Verständnisses, ist es möglich Therapien gezielter einzusetzen, Fehlbehandlungen zu vermeiden und zu einer größeren Patientenzufriedenheit zu gelangen.

Abstract

The group of acquired myasthenic syndromes can be divided into the postsynaptic myasthenias (MG) and the presynaptic Lambert-Eaton syndrome (LEMS). By improvement of diagnostic procedures (receptor-auto-antibody testing, electrophysiology, imaging, pharmacological testing) it is possible to refer the specific diseases to pathophysiologically defined subgroups. This enables a better and more specific therapy, e. g., indication for thymectomy or no thymectomy, different or more specific use of cholinesterase inhibitors for symptomatic treatment. Having more selective diagnostic as a consequence of the better pathophysiological understanding of the underlying processes at the neuromuscular synapsis, it is possible to use therapies more selectively, to avoid medical malpractice and to provide a better satisfaction for the patient.

Schlüsselwörter

Myasthenia gravis - neuromuskuläre Erkrankungen - Myasthenien - Lambert-Eaton Syndrom

Key words

Myasthenia gravis - neuromuscular diseases - Myasthenias - Lambert-Eaton Syndrome

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