Schmerzen bei Parkinson-Syndrom

Parkinsonpatienten klagen sehr häufig über Schmerzen und Missempfindungen. Dennoch werden Schmerzen bei Parkinsonpatienten häufig unterschätzt, fehldiagnostiziert und -behandelt. Opiate können die Parkinson-Symptomatik verschlechtern und Verwirrtheitszustände hervorrufen. Das therapeutische Vorgehen zielt zunächst auf eine Optimierung der dopaminergen Medikation, da Schmerzen meist mit der Akinese, dem Rigor, zusammenhängen und mit motorischen Fluktuationen korrelieren. In einem weiteren Schritt kommt ein multimodaler Therapieansatz mit Analgetika, Physiotherapie und psychoedukativen Maßnahmen zur Anwendung.

Pain and sensory complaints are common among Parkinson's disease patients. Despite its high prevalence in Parkinson's disease the burden of pain is often underestimated, misdiagnosed and not appropriately treated. Opioids can exacerbate rigidity and produce confusional states. Therapeutic strategies should firstly aim at a sufficient dopaminergic stimulation since pain is frequently linked to akinesia, rigidity and may fluctuate similarly to motor signs. Secondly, a multimodal approach including analgesics, physiotherapy and psychoeducation is frequently helpful to avoid chronification and impaired quality of life.

Key Words

pain - Parkinson's disease - parkinsonism

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