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Nervenheilkunde 2012; 31(10): 718-720
DOI: 10.1055/s-0038-1628184
Update Neurologie
Schattauer GmbH

Neurologische und psychiatrische Notfälle

Neurological and psychiatric emergencies
K. Schröder
1   Abteilung für Neurologie und Neurophysiologie des Krankenhauses der Barmherzigen Brüder Trier
,
C. Klawe
1   Abteilung für Neurologie und Neurophysiologie des Krankenhauses der Barmherzigen Brüder Trier
,
M. Maschke
1   Abteilung für Neurologie und Neurophysiologie des Krankenhauses der Barmherzigen Brüder Trier
› Institutsangaben
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Publikationsverlauf

Eingegangen am: 29. Mai 2012

angenommen am: 11. Juni 2012

Publikationsdatum:
23. Januar 2018 (online)

    Lizenzen und Reprints

Zusammenfassung

Bei der myasthenen Krise sind Plasmapherese und intravenöse Immunglobuline gleichwertig. Influenzaimpfungen führen nicht signifi-kant zu einer Risikoerhöhung eines GuillainBarré-Syndroms (GBS), während die Infektionen mit Influenzaviren und H1N1 mit einer erhöhten GBS-Rate assoziiert sind. Die intra -venöse und intraarterielle Lyse der Basilaris -thrombose sind möglicherweise gleichwertig, Bridging-Konzepte sind eventuell mit einer erhöhten Rekanalisierungsrate verbunden. Metaanalysen lassen an der Wirksamkeit von Dexamethason bei bakterieller Meningitis zweifeln. In der FAST-Studie konnte keine Verbesserung des Outcomes von Patienten mit intrazerebraler Blutung durch Gabe von rekombinantem Faktor VII a erzielt werden. Clazosentan (Endothelinrezeptorantagonist) war in der Prophylaxe von Vasospasmen nach SAB in der CONSCIOUS-I-Studie sicher und wirksam. Die Phase-III-Studie war negativ.

Summary

Recent trials showed no significant difference in efficacy between IVIG and plasmapheresis in the treatment of severe Myasthenia gravis. Vaccinations against influenza do not lead to a significant increased risk for GBS, whereas seasonal influenza and H1N1 infections are associated with an increased rate of GBS. In case of basilar artery occlusion no significant superiority can be found for treatment with intravenous or intra-arterial thrombolysis. Bridging concepts might provide better recanalization rates. The benefit of adjunctive dexamethasone in the treatment of acute bacterialmeningitis remains unproven. In FAST recombinant factor VII a did not improve clinical outcomes of patients with intra -cerebral hemorrhage. In CONSCIOUS-I Clazosentan (endothelin receptor antagonsist) significantlyprevented the occurrence of cerebral vasospasms following a SAH. However, CONSCIOUS- II showed negative results.

Schlüsselwörter

Notfall - Neurologie - Psychiatrie - Therapie

Keywords

Emergency - neurology - psychiatry - therapy
 

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