Medikamentenpumpen und tiefe Hirnstimulation bei Morbus Parkinson

Zusammenfassung

Medikamentenpumpen (Apomorphin subkutan, Dopa duodenal via perkutanen enteralen Gastrostomie = PEG) und die tiefe Hirnstimulation stellen aufwendige und kostspielige Therapien der Parkinsonkrankheit dar, deren Nachfrage stetig wächst. Die Hauptindikation sind hypokinetische Wirkfluktuationen oder Dyskinesien, wenn die Optimierungsmöglichkeiten der konventionellen, vor allen oralen Medikation, erschöpft sind. Ziel dieses CME-Artikels ist es, Indikationen sowie Vorteile und Nachteile der kontinuierlichen subkutanen Apomorphin, duodenalen Dopa-Infusion und der tiefe Hirnstimulation bei fortgeschrittene Parkinson-Krankheit vorzustellen.

Summary

There is an increasing demand for costly and complex therapeutic interventions in Parkinson’s disease such as medication pumps and deep brain stimulation. Main indications are hypokinetic fluctuations and dyskinesias when best treatment with oral medication fails.The aim of this CME review is to highlight the indications and the pro and cons for the use of the continuous subcutaneous infusion of apomorphine, the duodenal infusion of levodopa and deep brain stimulation.

Schlüsselwörter

Parkinsonsyndrom - Medikamentenpumpen - Apomorphin - Dopaminagonisten - L-Dopa - tiefe Hirnstimulation

Keywords

Parkinson’s disease - medication pumps - apomorphine - levodopamine agonists - dopamine - deep brain stimulation

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