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Nervenheilkunde 2010; 29(12): 807-811
DOI: 10.1055/s-0038-1628855
Schwabinger Neuro-Seminar
Schattauer GmbH

Diagnose und Therapie von Festination und Freezing

Diagnostic assessment and therapeutic approach to festination and freezing
K. Ziegler
1   Abteilung Neurologie und klinische Neurophysiologie, Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Schön Klinik, München Schwabing
,
F. Schroeteler
1   Abteilung Neurologie und klinische Neurophysiologie, Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Schön Klinik, München Schwabing
,
U. Fietzek
1   Abteilung Neurologie und klinische Neurophysiologie, Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Schön Klinik, München Schwabing
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Publication History

Eingegangen am: 06 September 2010

angenommen am: 06 September 2010

Publication Date:
31 January 2018 (online)

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Zusammenfassung

Motorische Blockaden während des Gehens sind als eine episodisch auftretende Störung der Ganginitiierung und des Lokomotionserhalts bei Parkinsonsyndromen und zentralen Gangstörungen definiert. Phänomenologisch werden Festination, trembling-in-place und total akinesia als Freezing-Formen unterschieden. Fünf differente Gangsituationen wurden als klassische Provokatoren für Freezing-Episoden benannt. Um eine Testung durch einen Beobachter klinisch einfach und aussagekräftig durchführen zu können, haben wir ein neues Testinstrument, den Freezing-ofgait-Score (FOG-Score) entwickelt, der im klinischen Alltag erprobt wird. Freezing bei Parkinsonpatienten ist meist dopasensitiv, kann aber auch im On-Zustand des Patienten auftreten und ist dann schwer zu therapieren.Wir diskutieren standardisierte Therapieschemata für Patienten mit On-Freezing, die wir an unserem Zentrum entwickelt haben.

Summary

Motor blocks during walking are defined as sudden episodic inabilities to initiate or sustain locomotion in Parkinson’s disease (PD) or other higher-level gait disorders. Phenomenologically festination is differentiated from trembling-in-place and from total akinesia. Five situations have been described as classical provoking environments. In order to clinically assess freezing with short-term time intervals we have developed a new scoring instrument that is currently further validated. Freezing is dopa-sensitive in most PD patients, however, it can occur during On-medication states, and then is difficult to treat. We report on physiotherapeutical approaches to overcome and reduce On-freezing by standarized treatment approaches.

Schlüsselwörter

Parkinson - Akinese - Festination - Freezing

Keywords

Parkinson’s disease - akinesia - festination - freezing
 

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