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Fortschr Neurol Psychiatr 2017; 85(07): 414-431
DOI: 10.1055/s-0043-113136
CME-Fortbildung
Georg Thieme Verlag KG Stuttgart · New York

Tiefe Hirnstimulation bei Bewegungsstörungen: Evidenz und Therapiestandards

Deep brain stimulation in movement disorders: evidence and therapy standards
Yaroslav Parpaley
,
Sabine Skodda
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Publication History

Publication Date:
02 August 2017 (online)

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Abstract

The deep brain stimulation (DBS) in movement disorders is well established and in many aspects evidence-based procedure. The treatment indications are very heterogeneous and very specific in their course and therapy. The deep brain stimulation plays very important, but usually not the central role in this conditions. The success in the application of DBS is essentially associated with the correct, appropriate and timely indication of the therapy in the course of these diseases. Thanks to the good standardization of the DBS procedure and sufficient published data, the recommendations for indication, diagnosis and operative procedures can be generated. The following article attempts to summarize the most important decision-making criteria and current therapy standards in this fairly comprehensive subject and to present them in close proximity to practice.

Die tiefe Hirnstimulation ist ein invasives Verfahren zur kontinuierlichen Neuromodulation und wird erfolgreich zur Therapie von verschiedenen chronischen neurologischen Erkrankungen eingesetzt. Dieser Beitrag schildert die aktuelle Studienlage zu Indikationen, Wirksamkeit und Therapiestandards der präzisen und individuell modulierbaren Technik.
Kernaussagen

  • Die THS ist ein invasives Verfahren zur kontinuierlichen Neuromodulation dysfunktionaler neuronaler Netzwerke. Etablierte Indikationen sind u. a. Morbus Parkinson, Tremor und Dystonie.

  • Die THS wird in etablierten Zielgebieten für Bewegungsstörungen, wie Nucleus subthalamicus, Nucleus ventralis intermedius und Globus pallidus internus, eingesetzt.

  • In den etablierten Zielgebieten verfügt die THS über gut dokumentierte Therapieeffekte und Nebenwirkungen, eine weitgehend standardisierte Implantationstechnik und eine verbreitete mehrstufige Qualitätssicherung.

  • Der langfristige optimale Therapieeffekt der THS basiert auf einer korrekten Indikationsstellung, einer optimalen prä-, intra- und postoperativen Betreuung sowie der langfristigen zuverlässigen Nachsorge.

  • Dies erfordert ein spezialisiertes multiprofessionelles Team, insbesondere bestehend aus Neurologen bzw. Neurochirurgen, unter bedarfsweiser Einbeziehung weiterer Fachdisziplinen.

Schlüsselwörter

tiefe Hirnstimulation - THS - Neuromodulation - Morbus Parkinson - Tremor
 

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