Kamptokormie bei Morbus Parkinson
Kamptokormie bei Morbus Parkinson
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Original abstract
" camptocormia ● " Parkinson syndromes ● " focal myopathy ● " paravertebral muscles ● " muscle biopsy Abstract ! This review is intended to give an overview of the clinical manifestations, diagnosis, aetiology and treatment approaches for camptocormia in Par- kinsonʼs disease (PD). Camptocormia is a distinct pathological flexion of the trunk during standing and walking that is completely reversible during recumbency. It occurs in a number of diseases, but in particular in Parkinson syndromes. For the affected patients with idiopathic PD camptocor- mia is often the predominant complaint, causing a serious limitation of independence and mobili- ty. Additionally, these patients suffer frequently from back pain associated with their camptocor- mia. In most cases, patients with the akinetic- rigid type of PD or the mixed-type variant are af- fected in an advanced stage of their PD, reporting frequently diseases or injuries of the spine in their anamnesis. The clinical definition of camptocor- mia can be distinguished from the typical for- ward-flexed posture of PD byour newly proposed diagnostic criteria. Recent research has empirical- ly demonstrated for the first time a focal myopa- thy of the paravertebral muscles as the major pathophysiological mechanism of camptocormia, although its aetiology is still unknown. Conside- rably less common but important competing aetiologies are focal myositis of the paravertebral muscles and dystonia of the trunk flexors. The diagnostics for the underlying aetiology should include laboratory analyses, EMG, muscle MRI and optionally muscle biopsy. However, the ther- apy for the mostly underlying focal myopathy of the paraspinal muscles is currently still unsatis- factory. In cases of myositis, a cortisone treatment is indicated, while in focal dystonia at first a treat- ment with botulinum toxin can be attempted.