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Neuroleptika-induzierte vs. genuine Bewegungsstörungen

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Zusammenfassung

Zwei Jahre, nachdem Delay und Deniker (1952) anlässlich einer Konferenz in Luxembourg erstmals ihre Erfahrungen mit dem später Chlorpromazin genannten RP 4560 bei der Behandlung deliranter und psychotischer Patienten referiert hatten, berichtete der Schweizer Neurologe Hans Steck über ein reversibles, dosisabhängiges extrapyramidales Syndrom mit Parkinsonismus und Akathisie, das er unter der Behandlung mit Chlorpromazin und Reserpin an 111 von 299 (37%) meist chronisch schizophrenen Patienten beobachtet hatte (Steck 1954). In Anlehnung an eine vergleichbare Symptomatik im Verlauf der Encephalitis lethargica (sein Spezialgebiet) benannte Steck die beobachtete Symptomatik als »extrapyramidales-diencephalesº Syndrom. Aufgrund früherer Beobachtungen an chronisch Schizophrenen, bei denen die Entwicklung eines Parkinson-Syndroms im Rahmen einer zusätzlichen Erkrankung an Encephalitis lethargica zu einer Besserung der schizophrenen Symptomatik geführt hatte, entwickelte Steck die nach ihm benannte Hypothese, dass Chlorpromazin ähnlich einer Encephalitis den natürlichen Verlauf der psychotischen Krankheit von einem erregten Initialstadium zu einem akinetischen, durch Aktivitätsverlust charakterisierten Stadium bis hin zur Möglichkeit einer Spontanheilung beschleunigen würde.

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Dose, M. (2004). Neuroleptika-induzierte vs. genuine Bewegungsstörungen. In: Jahn, T. (eds) Bewegungsstörungen bei Psychischen Erkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18533-5_2

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