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S1-Leitlinie: Diagnostik bei Polyneuropathien

Leitlinie der Deutschen Gesellschaft für Neurologie

S1 guideline: diagnosis of polyneuropathies

Guideline of the German Neurological Society

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DGNeurologie Aims and scope

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Abb. 1

Notes

  1. Medikamenteninduzierte Polyneuropathien: Neben den seit langem bekannten, potenziell polyneuropathieinduzierenden Medikamenten (Chemotherapeutika, INH [Isonikotinsäurehydrazid], Thalidomid, Chloroquin usw.) wurde in den letzten Jahren die Entstehung einer Polyneuropathie bei einigen Medikamenten beschrieben, für die das bisher nicht bekannt war. Statine verursachen nach langer Anwendung selten sensible und sensomotorische Polyneuropathien, die nach ihrem Absetzen reversibel sind [19]. Bortezomib (Velcade®), ein Proteasominhibitor, der bei der Therapie des multiplen Myeloms eingesetzt wird, verursacht schmerzhafte sensomotorische Polyneuropathien, die nur teilweise reversibel sind [20]. Linezolid, ein Antibiotikum aus der Oxazolidinongruppe, verursacht nach längerer Anwendung eine schmerzhafte sensomotorische Polyneuropathie und eine toxische Optikusneuropathie [21, 22]. Auch Medikamente, die in der Therapie von Neuropathien eingesetzt werden wie Rituximab, Tumor-Nekrose-Faktor-Blocker und auch Immuncheckpointinhibitoren wie Ipilimumab, Nivolumab oder Pembrolizumab können in Einzelfällen (immunvermittelte) Neuropathien auslösen [23].

  2. Die Tabellen (Tab. 8, 9, 10 und 11) erheben keinen Anspruch auf Vollständigkeit. Monatlich werden Mutationen in neuen Genen als Ursache von Neuropathien identifiziert, NGS-Panels unterscheiden sich in ihrer Zusammensetzung laborabhängig. Aktuell erschweren die Limitationen in der Abrechnung NGS-basierter Diagnostik nach EBM (evidenzbasierte Medizin) den medizinisch sinnvollen Einsatz von NGS zur molekularen Ursachenklärung

  3. Hochgestelltes a (Parametera): Jeder Nerv, der eines der Kriterien a–g erfüllt

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  1. Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland

    D. Heuß

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Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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P. Berlit, Berlin

Fachgesellschaft

Deutsche Gesellschaft für Neurologie (DGN)

Federführend

Prof. Dr. D. Heuß, Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054 Erlangen, E‑Mail: dieter.heuss@uk-erlangen.de

Redaktionskomitee

D. Heuß, Neurologische Klinik, Universitätsklinikum Erlangen

E. Hund, Neurologische Klinik, Amyloidosezentrum, Universitätsklinikum Heidelberg

J. Klehmet, Klinik für Neurologie, Charité Universitätsmedizin Berlin

I. Kurth, Institut für Humangenetik, Universitätsklinik RWTH (Rheinisch-Westfälische Technische Hochschule) Aachen

H. Lehmann, Klinik und Poliklinik für Neurologie, Universitätsklinikum Köln

C. Sommer, Neurologische Klinik, Universitätsklinikum Würzburg

Redaktionskomitee Österreich

W. Löscher, Neurologische Klinik, Medizinische Universität Innsbruck, Österreich

Redaktionskomitee Schweiz

S. Renaud, Département médecine, Hôpital neuchâtelois, Neuchâtel, Schweiz

Die vollständige Leitlinie wurde unter https://www.dgn.org/leitlinien/3754-ll-030-067-diagnostik-bei-polyneuropathien-2019 am 10.04.2019 publiziert.

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Heuß, D. S1-Leitlinie: Diagnostik bei Polyneuropathien. DGNeurologie 2, 359–382 (2019). https://doi.org/10.1007/s42451-019-0099-6

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