Zusammenfassung
Über 70% aller Patienten mit Amputationen leiden an Phantomgefühlen oder Phantomschmerzen
und sind auch deswegen in ihrer Funktion, Aktivität, Partizipation und Lebensqualität
beeinträchtigt. Die Entstehung der Postamputationsphänomene wird durch Reorganisation
des somatosensorischen Kortex, durch Entwicklung eines Schmerzgedächtnisses und mithilfe
verschiedener psychologischer Theorien zu erklären versucht. Basierend auf diesen
Ansätzen sind in den letzten Jahrhunderten verschiedene Therapien entwickelt worden,
von denen bis heute keine einzige überzeugende Ergebnisse erzielt hat. Trotzdem scheint
ein individuelles, meist multimodales und interdisziplinäres Eingehen auf den jeweiligen
Patienten mit physikalisch-medizinischen, medikamentösen, psychologischen und chirurgischen
Interventionen in vielen Fällen eine vorübergehende oder permanente Schmerzerleichterung
zu erzielen.
Abstract
More than 70% of all patients undergoing amputation develop phantom limb sensation
or phantom limb pain and consequently display deficiencies in function, activity,
participation and quality of life. Cortical reorganisation, existence of a pain memory
and several psychological theories are put forward to explain the development of postamputation
phenomena. In the last centuries, several therapies have been developed on the basis
of these concepts with none of them producing convincing results. However, in many
cases, a transitory or permanent pain relief seems to be achieved by individual, multimodal
and interdisciplinary focus on the patient using physical-medical, pharmacological,
psychological and surgical interventions.
Schlüsselwörter
Amputation - Phantomschmerz - Rehabilitation - interdisziplinäres Konzept
Key words
amputation - phantom limb pain - rehabilitation - interdisciplinary management
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Korrespondenzadresse
ao. Univ.-Prof. Dr. R. Crevenna
Universitätsklinik für Physikalische Medizin und Rehabilitation
AKH Wien
Währinger Gürtel 18-20
1090 Wien
Österreich
Phone: +43/1/404 00 43 30
Fax: +43/1/404 00 52 81
Email: richard.crevenna@meduniwien.ac.at