Fabra M
Medizinisches Gutachteninstitut, Mönckebergstraße 5, Hamburg.
Fortschr Neurol Psychiatr. 2010 Dec;78(12):722-32. doi: 10.1055/s-0029-1245636. Epub 2010 Dec 6.
The basis for medical expert reports must always be what is commonly known as the scientific consensus. For some neurological disorders, no more impressive changes in this scientific doctrine can be seen as those made for the dystonias over the last 100 years. The post-traumatic dystonia subsequent to peripheral trauma is an especially impressive example of these changes, as it has been almost completely accepted as a neurological disorder since the 1980 s, having consequences for the practice of medical evaluation and compensation. But since around 2005, voices have been increasingly heard highlighting the psychogenesis, or even the deliberate display of combinations of symptoms. After reviewing the literature, it is arguable if this disorder, as seen from the scientific consensus, exists as an actual disease. The discussion in the context of medical evaluation and the consequences for social medicine and insurance law are the focus of this review.
医学专家报告的依据必须始终是通常所说的科学共识。对于某些神经系统疾病,在过去100年里,科学理论中没有比肌张力障碍更显著的变化了。外周创伤后创伤性肌张力障碍就是这些变化中一个特别突出的例子,自20世纪80年代以来,它几乎已被完全认定为一种神经系统疾病,这对医学评估和赔偿实践产生了影响。但自2005年左右以来,越来越多的声音强调心理成因,甚至是症状组合的故意表现。在查阅文献后,可以说从科学共识的角度来看,这种疾病是否作为一种实际疾病存在是有争议的。在医学评估背景下的讨论以及对社会医学和保险法的影响是本综述的重点。