Cholinerge Krise

Eine cholinerge Krise entsteht durch ein Überangebot des Neurotransmitters Acetylcholin (ACh).[1] Sie wird häufig durch Medikamente wie Cholinesterasehemmer verursacht, die beispielsweise bei der Therapie einer Myasthenia gravis eingesetzt werden. Auch Nervenkampfstoffe oder Pflanzenschutzmittel (Phosphorsäureester) bzw. andere Toxine können zu einer cholinergen Krise führen.[2]

Symptome

Eine cholinerge Krise zeigt sich in einer akuten Muskelschwäche. Zusätzlich kommt es zu Symptomen wie sie auch bei Muscarin- und Nicotinvergiftungen auftreten. Zu den muscarinartigen Symptomen gehören:[3]

Behandlung

Die muscarinartigen Symptome sprechen gut auf die Behandlung mit Atropin an. Zur Behebung der nikotinergen Begleiterscheinungen ist meist eine Intubation und Beatmung notwendig.[3]

Abgrenzung zur myasthenischen Krise

Eine myasthenische Krise kann ähnliche Symptome hervorrufen (diese tritt meist bei Infektionen bei einer Myasthenia gravis auf), hier fehlen typischerweise die nikotinartigen (Faszikulationen und Krämpfe der Muskulatur) und muskarinartigen (Hypersekretion, Bradykardie und Diarrhoen) Auswirkungen.[4]

Einzelnachweise

  1. ↑ DocCheck Medical Services GmbH: Cholinerge Krise. Abgerufen am 14. Juni 2019.
  2. ↑ DS Reddy: A Comparative Toxidrome Analysis of Human Organophosphate and Nerve Agent Poisonings Using Social Media.
  3. ↑ a b Peter Berlit: Klinische Neurologie. 2. Auflage. Springer Science & Business Media, 2005, ISBN 978-3-540-01982-4, S. 295.
  4. ↑ WF Haupt: Intensivmedizinische Therapie der myasthenischen Krise. Abgerufen am 14. Juni 2019.

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