Denervation

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As denervation , even enervation or enervation ( Engl. Denervation ) called, refers to the complete or partial interruption of nerve pathways between an organ and the brain or a cerebral area of its neural connections.

Forms of denervation

Denervation can be targeted, for example to combat chronic pain , spastic paralysis such as infantile spastic diplegia ( Little's syndrome ), certain central motor disorders (including Parkinson's disease ), or it can be an undesirable consequence of trauma or a neurological disease which the nerve tracts are interrupted.

Methods of denervation

In a neurotomy ('nerve incision'), the nerve fibers are completely or partially severed. This can be done with a scalpel , for example . Radiofrequency neurotomy , in which the nerve tracts are thermally severed, is now more common.

In contrast to neurotomy, a section of the nerve is deliberately cut out in neurectomy . Neurectomy is the last resort for chronic pain conditions.

In a sympathectomy , individual ganglia of the sympathetic nerve are surgically cut.

Denervation can also be done chemically, for example by injecting ethanol , phenol or botulinum toxin . Nerve tracts can also be severed with a laser .

Special forms of denervation

Special forms of denervation are:

Individual evidence

  1. ↑ Denervation. Roche Lexicon Medicine, 5th edition.
  2. ^ KK Post, C. Singer, S. Papapetropoulos: Cardiac denervation and dysautonomia in Parkinson's disease: a review of screening techniques. In: Parkinsonism & related disorders. Volume 14, Number 7, November 2008, pp. 524-531, ISSN  1353-8020 . doi : 10.1016 / j.parkreldis.2008.03.008 . PMID 18486523 . (Review).
  3. ↑ DS Goldstein: Cardiac denervation in patients with Parkinson's disease. In: Cleveland Clinic journal of medicine. Volume 74 Suppl 1, February 2007, pp. S91-S94, ISSN  0891-1150 . PMID 17455553 . (Review).
  4. ↑ R. Chou, SJ Atlas et al. a .: Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline. In: Spine. Volume 34, Number 10, May 2009, pp. 1078-1093, ISSN  1528-1159 . doi : 10.1097 / BRS.0b013e3181a103b1 . PMID 19363456 . (Review).
  5. ↑ SA Shah, MN Khan et al. a .: Is peripheral alcohol injection of value in the treatment of trigeminal neuralgia? An analysis of 100 cases. In: International journal of oral and maxillofacial surgery. Volume 40, Number 4, April 2011, pp. 388-392, ISSN  1399-0020 . doi : 10.1016 / j.ijom.2010.11.010 . PMID 21168309 .
  6. ↑ M. Connolly, D. de Berker: Management of primary hyperhidrosis: a summary of the different treatment modalities. In: American Journal of Clinical Dermatology . Volume 4, Number 10, 2003, pp. 681-697, ISSN  1175-0561 . PMID 14507230 . (Review).
  7. ↑ M. Manca, A. Merlo et al. a .: Botulinum toxin type A versus phenol. A clinical and neurophysiological study in the treatment of ankle clonus. In: European journal of physical and rehabilitation medicine. Volume 46, Number 1, March 2010, pp. 11-18, ISSN  1973-9095 . PMID 20332721 .
  8. ^ A. Müller, R. Gottschall, F. Paulsen: A case of chondronecrosis of the epiglottis after laser chordotomy. In: European archives of oto-rhino-laryngology. Volume 259, Number 10, November 2002, pp. 524-526, ISSN  0937-4477 . doi : 10.1007 / s00405-002-0493-7 . PMID 12434185 .
  9. ↑ Renal denervation S1 recommendation of the German Society for General Medicine and Family Medicine AWMF - Register number 053/049.
  10. ^ MP Schlaich, H. Krum u. a .: Renal denervation and hypertension. In: American journal of hypertension. Volume 24, Number 6, June 2011, pp. 635-642, ISSN  1941-7225 . doi : 10.1038 / year 2011.35 . PMID 21394087 . (Review).
  11. ↑ F. Mahfoud, M. Böhm: Interventional Renal Sympathetic Denervation - Background. ( Memento of the original from May 5, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. As of May 25, 2011. @1@ 2Template: Webachiv / IABot / www.medfuehrer.de
  12. ↑ HA Oliveira, M. Ximenes et al. a .: Experimental selective sympathicotomy (ramicotomy) and sympathetic regeneration. In: Interactive cardiovascular and thoracic surgery. Volume 9, Number 3, September 2009, pp. 411-415, ISSN  1569-9285 . doi : 10.1510 / icvts.2009.202150 . PMID 19564204 .
  13. ↑ NT Oran: Percutaneous chordotomy for managing cancer pain. In: AORN journal. Volume 74, Number 3, September 2001, pp. 363-9, 371, ISSN  0001-2092 . PMID 11565157 . (Review).
  14. ↑ R. Abbott: Sensory rhizotomy for the treatment of childhood spasticity. In: Journal of child neurology. Volume 11 Suppl 1, November 1996, pp. S36-S42, ISSN  0883-0738 . PMID 8959460 . (Review).
  15. ^ Stoffel operation. Roche Lexicon Medicine, 5th edition.
  16. ↑ AH Lebovits, M. Lefkowitz: Pain management of pancreatic carcinoma: a review. In: Pain. Volume 36, Number 1, January 1989, pp. 1-11, ISSN  0304-3959 . PMID 2465529 . (Review).
  17. ↑ S. Hollerbach: Endosonographically controlled plexus celiacus blockade (EUS-FNI) . In: CF Dietrich (Hrsg.): Endosonographie: textbook and atlas of endoscopic ultrasound. Georg Thieme Verlag, 2008, ISBN 3-131-45601-9 , pp. 448-455. limited preview in Google Book search