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Therapieempfehlungen der Früh- und Spätphase der Parkinson-Krankheit

  • W. Oertel

Zusammenfassung

Der Parkinson-Krankheit (PK) liegt eine langsam-progressive Degeneration nigraler dopaminerger Neurone zugrunde, welche zu einer Dopamindepletion im Bereich nigrostriataler Afferenzen fÜhrt. Positron-Emissions-Tomographie (PET)-Studien, welche die dopaminerge FunktionstÜchtigkeit nigrostriataler Afferenzen untersuchten, weisen darauf hin, daß die präsymptomatische Krankheitsphase wahrscheinlich weniger als 10 Jahre beträgt. Nach Ablauf dieser Frist, bei der es zu einer mindestens 50%igen Degeneration von dopaminergen Substantia nigra-Neuronen und einer 70–80%igen Dopaminreduktion im Striatum gekommen ist, treten erstmals die PK-typi-schen motorischen Symptome, insbesondere die Trias Akinese, Rigor und Ruhetremor, auf. Im weiteren Verlauf kÖnnen posturale Instabilität, GangstÖrungen, kognitive und psychopathologische Auffälligkeiten sowie vegetative Störungen hinzutreten.

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  • W. Oertel

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