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Nervenheilkunde 2016; 35(04): 222-229
DOI: 10.1055/s-0037-1616380
Parkinson
Schattauer GmbH

Eskalationstherapien bei Morbus Parkinson

Medikamentenpumpen und tiefe HirnstimulationMedication pumps and deep brain stimulation in Parkinson’s DiseaseDrug pumps and deep brain stimulation
A. O. Ceballos-Baumann
1   Abt. für Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Schön Klinik München Schwabing
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Publication History

eingegangen am: 10 February 2016

angenommen am: 19 February 2016

Publication Date:
10 January 2018 (online)

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Zusammenfassung

Medikamentenpumpen mit Apomorphin subkutan oder mit Levodopa/Carbidopa-Gel jejunal via perkutaner enteralen Gastrostomie (PEG) und die tiefe Hirnstimulation stellen die Eskalationstherapien bei Levodopa-Wirkfluktuationen und Dyskinesien dar, wenn die Optimierungsmöglichkeiten der oralen Medikation erschöpft sind. Bei unterschiedlicher Datenlage und Patientenpräferenzen dieser drei Eskalationstherapien ist die Beratung schwierig. Die Entscheidung muss in einem Abwägungsprozess zusammen mit dem Patienten und den Betreuungspersonen diskutiert werden. Ziel dieses CME-Artikels ist es, Indikationen sowie Vorteile und Nachteile dieser drei Eskalationstherapien bei der Parkinson-Krankheit vorzustellen.

Summary

Medication pumps (subcutaneous apomorphine, jejunal levodopa infusion) and deep brain stimulation are treatment options for levodopa-fluctuations and dyskinesias when best treatment with oral medication fails. There are differences in the evidence and patient preferences of these treatment options. The decision which option to choose has to be taken with the patient and care-givers. 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

Parkinson-Syndrom - Medikamentenpumpen - Apomorphin - Dopaminagonisten - jejunale Levodopa-Infusion - tiefe Hirnstimulation

Keywords

Parkinson’s disease - medication pumps - apomorphine - dopamine agonists - jejunal levodopa infusion
 

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