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Autoimmunerkrankungen

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Zusammenfassung

In diesem Kapitel werden die typischen autoimmunologischen Erkrankungen wie fulminante entzündliche demyelinisierende Erkrankungen, Autoimmunenzephalitiden, Vaskulitiden, SLE und Sarkoidose zusammengefasst. Erkrankungen wie die ADEM sind verbunden mit rasch progredienten neurologischen Defiziten bis zur Bewusstseinsstörung mit Zeichen erhöhter ICP, Anfällen und Einbruch der vitalen Funktionen wie Atmung und Kreislauf, wodurch eine Intensivbehandlung notwendig wird. Autoimmune Enzephalopathien sind Erkrankungen der grauen Substanz, die durch den Nachweis distinkter Autoantikörper in Serum und/oder Liquor diagnostiziert werden können, ob nun paraneoplastischer Ätiologie oder idiopathisch bedingt. Die zerebrale Vaskulitis, isoliert wie begleitend zu umschriebenen systemischen Vaskulitiden, präsentiert sich oft unter dem Bild eines Schlaganfalls mit oder ohne Kopfschmerzen, psychopathologischen Auffälligkeiten oder epileptischen Anfällen. Auch die Sarkoidose gehört zu diesen Krankheiten, wobei die Neurosarkoidose eher subakut verläuft. Eine neurologische Beteiligung bei SLE verläuft typischerweise chronisch progredient mit Schüben. Die Differenzialdiagnose ist oft schwierig, wobei die Therapie in allen Fällen eine Immunsuppression einschließt (Coriticoidstoß, PE, IVIGs, Cyclophosphamid u. a.).

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Authors and Affiliations

  1. Klinik für Neurologie mit Klinischer Neurophysiologie, Alfried-Krupp-Krankenhaus Rüttenscheid, Alfried-Krupp-Str. 21, 45131, Essen, Deutschland

    Peter Berlit Prof. Dr. & Markus Krämer PD Dr.

  2. Neurologische Fachabteilung, GRN-Klinik, Alte Waibstadter Str. 2, 74889, Sinsheim, Deutschland

    Brigitte Storch-Hagenlocher Dr.

  3. Sektion Molekulare Neuroimmunologie Neurologische Universitätsklinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Brigitte Wildemann Prof. Dr.

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  1. Brigitte Storch-Hagenlocher Dr.
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  2. Brigitte Wildemann Prof. Dr.
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  1. Neurologische Klinik, Universitätklinikum Erlangen, Erlangen, Germany

    Stefan Schwab

  2. Neurologische Klinik und Geriatrie, Johannes Wesling Klinikum Minden, Minden, Germany

    Peter Schellinger

  3. Klinik für Anästhesiologie, Klinikum der Johannes-Gutenberg-Universität Mainz, Mainz, Germany

    Christian Werner

  4. Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany

    Andreas Unterberg

  5. Neurologische Klinik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany

    Werner Hacke

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Storch-Hagenlocher, B., Wildemann, B., Berlit, P., Krämer, M. (2015). Autoimmunerkrankungen. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46500-4_33

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