Interdisziplinäres Therapiemanagement bei Phantomschmerz

 

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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.

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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