Zusammenfassung
Nervenkompressionssyndrome („Engpass-Syndrome“) wie Karpaltunnelsyndrom, Radikulopathien oder radikulärer Schmerz sind die häufigsten peripheren Nervenläsionen und auch die häufigste Ursache für neuropathischen Schmerz. Trotz ihrer hohen Prävalenz stellen sie diagnostisch und therapeutisch weiterhin oft eine klinische Herausforderung dar. Die vorliegende Übersicht bietet aktuelle Informationen zur Ätiologie und Pathophysiologie von Nervenkompressionssyndromen; dafür wird die Evidenz aus präklinischen wie auch klinischen Studien zusammengefasst. Mögliche Mechanismen werden in den Kontext klinischer Befunde gestellt. Das aktuelle diagnostische Vorgehen wird erörtert, diagnostische Fallstricke werden beleuchtet. Zuletzt fasst der Beitrag die Evidenz für die nichtinvasive und chirurgische Therapie häufiger Nervenkompressionssyndrome zusammen und zeigt zukünftige Forschungsbereiche auf.
Abstract
Entrapment neuropathies such as carpal tunnel syndrome, radiculopathies, or radicular pain are the most common peripheral neuropathies and also the most common cause for neuropathic pain. Despite their high prevalence, they often remain challenging to diagnose and manage in a clinical setting. Summarising the evidence from both preclinical and clinical studies, this review provides an update on the aetiology and pathophysiology of entrapment neuropathies. Potenzial mechanisms are put in perspective with clinical findings. The contemporary assessment is discussed and diagnostic pitfalls highlighted. The evidence for the noninvasive and surgical management of common entrapment neuropathies is summarised and future areas of research are identified.
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A.B. Schmid erhält Unterstützung vom National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). Brigitte Tampin erhielt Unterstützung von der Regierung Westaustraliens, Gesundheitsministerium, und von der Raine Medical Research Foundation. Der Beitrag spiegelt die Ansichten der Autoren wider, nicht unbedingt die von NHS, NIHR oder dem Gesundheitsministerium.
Übersetzung: Ansgar Schlichting.
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Deutsche Fassung von: Schmid AB, Fundaun J, Tampin B (2020) Entrapment neuropathies: a contemporary approach to pathophysiology, clinical assessment, and management. Pain Clinical Updates in Pain Reports. PR9 5 (2020) e829. https://doi.org/10.1097/PR9.0000000000000829. Publikation auf Deutsch mit Genehmigung der International Association for the Study of Pain und der Autoren. Verantwortlich: Frau Prof. Dr. C. Sommer, Würzburg
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Schmid, A.B., Fundaun, J. & Tampin, B. Nervenkompressionssyndrome – eine aktuelle Betrachtung von Pathophysiologie, klinischer Untersuchung und Management. Schmerz 35, 419–433 (2021). https://doi.org/10.1007/s00482-021-00584-z
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DOI: https://doi.org/10.1007/s00482-021-00584-z
Schlüsselwörter
- Nervenkompressionssyndrome
- Engpass-Syndrome
- Karpaltunnelsyndrom
- Ischialgie
- Radikulopathie
- Radikulärer Schmerz
- Pathomechanismen
- Untersuchung
- Diagnostik
- Management
- Therapie