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Nervenheilkunde 2009; 28(12): 875-878
DOI: 10.1055/s-0038-1628699
Schwabinger Neuro-Seminar
Schattauer GmbH

Schmerzen bei Multipler Sklerose

Pain and multiple sclerosis
M. Paulig
1   Abteilung für Neurologie und klinische Neurophysiologie, Neurologisches Krankenhaus München, Schön Kliniken
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Publication History

Eingegangen am: 21 August 2009

angenommen am: 24 August 2009

Publication Date:
24 January 2018 (online)

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Zusammenfassung

Über viele Jahrzehnte waren Schmerzen ein unterschätztes Problem bei Patienten mit Multipler Sklerose (MS). Neue Studien zeigen eine Prävalenz von schmerzhaften Symptomen von über 80% mit einem erheblichen Einfluss auf Alltagsaktivitäten und Lebensqualität. Schmerzsyndrome können in vier Kategorien bezüglich ihrer Genese klassifiziert werden: 1. Schmerzen direkt durch MS bedingt, z. B. neuropathische Schmerzen; 2. Schmerzen indirekt durch MS bedingt, z. B. Spastik assoziierte Schmerzen; 3. Schmerzen durch MSTherapie, z. B. Nebenwirkungen von Immunmodulanzien; 4. Schmerzen nicht durch MS bedingt. Die Behandlung sollte individuell angepasst erfolgen, wobei im Einzelfall der Nutzen gegen mögliche Nebenwirkungen abzuwägen ist. Speziell bei chronischen Schmerzen ist eine mehrdimensionale Therapie erforderlich, die neben medikamentösen auch nicht medikamentöse Behandlungen wie Physiotherapie oder kognitive Verhaltenstherapie mit einschließt.

Summary

For many decades pain has been an underestimated problem in patients with multiple sclerosis (MS). Recent studies showed a prevalence of painful symptoms up to more than 80% with a high impact on activities of daily life and quality of life. Pain syndromes can be divided into four categories of origin: 1. pain directly related to MS, e. g. neuropathic pain; 2. pain indirectly related to MS, e. g. pain associated with spasticity; 3. pain related to MS therapy, e. g. side effects of disease modifying drugs; 4. pain not related to MS. Therapy should be tailor made weighing the individual benefit against possible side effects. Particularly the treatment of chronic pain requires a multidimensional approach that apart from medication consists of non-pharmacological strategies, like physiotherapy and cognitive behavioural therapy.

Schlüsselwörter

Multiple Sklerose - Schmerz - Behandlung

Keywords

Multiple sclerosis - pain - treatment
 

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