Kernaussagen
Potenziell intensivpflichtige entzündliche Erkrankungen des Nervensystems kann man
in Infektionskrankheiten, Komplikationen dieser Infektionskrankheiten, immunvermittelte
Erkrankungen und Autoimmunerkrankungen einteilen.
Symptome, die das ZNS direkt betreffen sind u. a. Bewusstseinsstörung, fokale neurologische
Symptome und epileptische Anfälle. Treten neurologische Symptome auf, muss man differenzialdiagnostisch
stets an eine entzündliche ZNS-Erkrankung denken.
Ziel ist es, keine Zeit durch aufwendige Diagnostik zu verlieren und gleichzeitig
dennoch eine zielgerichtete Behandlung zu ermöglichen.
Diagnostik und Therapie umfassen folgende Schritte:
-
Sicherung der Vitalfunktionen, Behandlung akut lebensbedrohlicher Probleme
-
neurologische Basisdiagnostik
-
früher Therapiebeginn (oft empirisch)
-
Komplettierung der neurologischen Diagnostik
-
Anpassung der Therapie an die endgültige Diagnose
-
Berücksichtigung rehabilitativer und psychischer Aspekte
Die ersten 3 genannten Maßnahmen sollten in einem sehr kurzen Zeitraum durchgeführt
werden – möglichst innerhalb von 1 h nach Aufnahme in die Klinik.
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Prof. Dr. Martin Häusler
Universitätsklinik für Kinder- und Jugendmedizin
Pauwelsstr. 30
52074 Aachen
Telefon: 0241/800
Fax: 0241/8082484
eMail: haeusler@rwth-aachen.de
