Emergency conditions in Parkinson's disease
Keywords:
Parkinson's disease, emergency conditions, delirium, acute psychosis, parkinsonismus-hyperpyrexia syndrome, dyskinesia-hyperpyrexia syndrome
Abstract
Abstract
Parkinson's disease (PD) is a chronic, neurodegenerative disorder that in certain stages can present a series of acute symptoms and signs, the development of which lasts several hours or days. Emergencies in PD can be a direct consequence of the pathophysiology of the disease or a secondary consequence of the administration of antiparkinsonian drugs. Urgent conditions in PD can also occur due to falls, infectious diseases, after deep brain stimulation or surgical treatment of other accompanying diseases. This article describes the following emergency conditions: parkinsonism-hyperpyrexia syndrome, dyskinesia-hyperpyrexia syndrome, occurrence of acute psychosis and delirium during PD. Morbidity and mortality in these disorders are a consequence of the inability to make a timely diagnosis and provide appropriate therapeutic treatment. Timely diagnosis and treatment are very important for reducing the mortality and morbidity rates.
References
References
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9.Newman EJ, Grosset DG, Kennedy PGE. The parkinsonism-hyperpyrexia syndrome. Neurocrit Care 2009;10:136–40. doi:10.1007/s12028-008-9125-4.
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28.Robottom BJ, Weiner WJ, Factor SA. Movement disorders emergencies. Part 1: Hypokinetic disorders. Arch Neurol. 2011 May;68(5):567-72. doi: 10.1001/archneurol.2011.84.
29.Tousi B. Movement disorder emergencies in the elderly: recognizing and treating an often-iatrogenic problem. Cleve Clin J Med. 2008 Jun;75(6):449-57. doi: 10.3949/ccjm.75.6.449.
30.Vaughan CL, Goldman JG. Psychosis and Parkinson’s disease. In: Frucht SJ, editor. Movement disorder emergencies: Diagnosis and treatment. New York: Humana Press; 2013. pp. 75–92.
31.Kalabalik J, Brunetti L, El Srougy R. Intensive care unit delirium: a review of the literature. J Pharm Pract 2014;27(2):195–207.doi: 10.1177/0897190013513804.
32.Burns A, Gallagley A, Byrne J. Delirium. J Neurol Neurosurg Psychiatry 004;75(3):362–7. doi: 10.1136/jnnp.2003.023366.
33.Vardy ER, Teodorczuk A, Yarnall AJ. Review of delirium in patients with Parkinson’s disease. J Neurol 2015;262(11):2401–10. doi: 10.1007/s00415-015-7760-1.
34.Seppi K, Weintraub D, Coelho M, Perez-Lloret S, Fox SH, Katzenschlager R, et al. The movement disorder society evidence - based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord 2011;26(Suppl 3):S42–80. doi: 10.1002/mds.23884.
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38.Weintraub D, Mamikonyan E. The neuropsychiatry of Parkinson disease: A perfect storm. The American Journal of Geriatric Psychiatry. 2019;27(9):998–1018. doi: 10.1016/j.jagp.2019.03.002.
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46.Cole MG, Ciampi A, Belzile E, Zhong L. Persistent delirium in older hospital patients: A systematic review of frequency and prognosis. Age and Ageing. 2009;38(1):19–26. doi: 10.1093/ageing/afn253.
47.Dasgupta M, Hillier LM. Factors associated with prolonged delirium: A systematic review. International Psychogeriatrics. 2010;22(3):373–394. doi: 10.1017/S1041610209991517.
48.Lawson RA, McDonald C, Burn DJ. Defining delirium in idiopathic Parkinson’s disease: A systematic review. Parkinsonism & Related Disorders. 2019;64:29–39. doi: 10.1016/j.parkreldis.2018.09.025.)
49.Lawson RA, Richardson SJ, Yarnall AJ, Burn DJ, Allan LM. Identifying delirium in Parkinson disease: A pilot study. International Journal of Geriatric Psychiatry. 2020;35(5):547–552. doi: 10.1002/gps.5270.
50.Chang A, Fox SH. Psychosis in Parkinson’s disease: Epidemiology, pathophysiology, and management. Drugs. 2016;76(11):1093–1118. doi: 10.1007/s40265-016-0600-5.
51.Serrano-Dueñas M, Bleda MJ. Delirium in Parkinson’s disease patients. A five-year follow-up study. Parkinsonism & Related Disorders. 2005;11(6):387–392. doi: 10.1016/j.parkreldis.2005.05.002.
52.Li H, Han S, Feng J. Delirium after Deep Brain Stimulation in Parkinson's Disease. Parkinsons Dis. 2021 Feb 1;2021:8885386. doi: 10.1155/2021/8885386.
1.Poston KL, Frucht SJ. Movement disorder emergencies. J Neurol. 2008;255(Suppl. 4):2–13. doi: 10.1007/s00415-008-4002-9.
2.Kalia LV, Lang AE. Parkinson's disease. Lancet. 2015 Aug 29;386(9996):896-912. doi: 10.1016/S0140-6736(14)61393-3.
3.Simonet C, Tolosa E, Camara A, Valldeoriola F. Emergencies and critical issues in Parkinson's disease. Pract Neurol. 2020 Feb;20(1):15-25. doi: 10.1136/practneurol-2018-002075.
4.Prasad S, Pal PK. When time is of the essence: Managing care in emergency situations in Parkinson's disease. Parkinsonism Relat Disord. 2019 Feb;59:49-56. doi: 10.1016/j.parkreldis.2018.09.016.
5.Mizuno Y, Takubo H, Mizuta E, Kuno S. Malignant syndrome in Parkinson's disease: concept and review of the literature. Parkinsonism Relat Disord. 2003 Apr;9 Suppl 1:S3-9. doi: 10.1016/s1353-8020(02)00125-6.
6.Munhoz RP, Moscovich M, Araujo PD, Teive HA. Movement disorders emergencies: a review. Arq Neuropsiquiatr. 2012 Jun;70(6):453-61. doi: 10.1590/s0004-282x2012000600013.
7.Onofrj M, Thomas A. Acute akinesia in Parkinson disease. Neurology 2005;64:1162–9. doi:10.1212/01.WNL.0000157058.17871.7B
8.Friedman JH, Feinberg SS, Feldman RG. A Neuroleptic malignant-like syndrome due to levodopa therapy withdrawal. JAMA. 1985;15:2792–2795. doi: 10.1001/jama.1985.03360190098033.
9.Newman EJ, Grosset DG, Kennedy PGE. The parkinsonism-hyperpyrexia syndrome. Neurocrit Care 2009;10:136–40. doi:10.1007/s12028-008-9125-4.
10.Granner MA, Wooten GF. Neuroleptic malignant syndrome or parkinsonism hyperpyrexia syndrome. Semin Neurol. 1991;11:28–235. doi: 10.1055/s-2008-1041226.
11.Kadowaki T, Hashimoto K, Suzuki K, Watanabe Y, Hirata K. Case report: recurrent parkinsonism-hyperpyrexia syndrome following discontinuation of subthalamic deep brain stimulation. Mov Disord. 2011;26:1561–1562. doi: 10.1002/mds.23596
12..Kuno S, Mizuta E, Yamasaki S. Neuroleptic malignant syndrome in parkinsonian patients: risk factors. Eur Neurol. 1997;38:56–59. doi: 10.1159/000113484.
13.Onofrj M, Bonanni L, Cossu G, et al.. Emergencies in parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-Dopa gel treatment. Park Realt Disord 2009;15:S233–6. doi: 13.10.1016/S1353-8020(09)70821-1.
14.Wang JY, Huang JF, Zhu SG, Huang SS, Liu RP, Hu BL, Zhu JH, Zhang X. Parkinsonism-Hyperpyrexia Syndrome and Dyskinesia-Hyperpyrexia Syndrome in Parkinson's Disease: Two Cases and Literature Review. J Parkinsons Dis. 2022;12(6):1727-1735. doi: 10.3233/JPD-223362.
15.Frucht SJ. Treatment of movement disorder emergencies. Neurotherapeutics 2014;11:208–12. doi:10.1007/s13311-013-0240-3.
16.Ghosh R, Liddle BJ. Emergency presentations of Parkinson's disease: early recognition and treatment are crucial for optimum outcome. Postgrad Med J 2011;87:125–31. doi: 10.1136/pgmj.2010.104976.
17. Clarke CE. Efficacy of methyprednisolone pulse therapy on neuroleptic malignant syndrome in Parkinson's disease. J Neurol Neurosurg Psychiatry 2004;75:510–1.
18.Sato Y, Asoh T, Metoki N, Satoh K. Efficacy of methylprednisolone pulse therapy on neuroleptic malignant syndrome in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2004;74:574–576. doi: 10.1136/jnnp.74.5.574.
19.Gordon PH, Frucht SJ. Neuroleptic malignant syndrome in advanced Parkinson's disease. Mov Disord. 2001;16(5):960–962. doi: 10.1002/mds.1166.
20.Richard IH, Kurlan R, Tanner C, Factor S, Hubble J, Suchowersky O, Waters C. Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson's disease. Parkinson Study Group Neurology. 1997;48(4):1070–1077. doi: 10.1212/wnl.48.4.1070.
21.Gil-Navarro S, Grandas F. Dyskinesia-hyperpyrexia syndrome: another Parkinson's disease emergency. Mov Disord. 2010 Nov 15;25(15):2691-2. doi: 10.1002/mds.23255.
22.Wang M, Wang W, Gao Z, Yin X, Chen T, Jiang Z, Wang Z. Dyskinesia-hyperpyrexia syndrome in Parkinson's disease: a systematic review. Clin Auton Res. 2021 Aug;31(4):529-542. doi: 10.1007/s10286-021-00801-w.
23.Herreros-Rodriguez J, Sánchez-Ferro Á. Summertime Dyskinesia-Hyperpyrexia Syndrome: The "Dual Heat" Hypothesis. Clin Neuropharmacol. 2016 Jul-Aug;39(4):210-1. doi: 10.1097/WNF.0000000000000155.
24.Leclair-Visonneau L, Magy L, Volteau C, Clairembault T, Le Dily S, Preterre C, Peyre A, Damier P, Neunlist M, Pereon Y, Derkinderen P. Heterogeneous pattern of autonomic dysfunction in Parkinson's disease. J Neurol. 2018 Apr;265(4):933-941. doi: 10.1007/s00415-018-8789-8.
25. Wang JY, Wang MY, Liu RP, Li Y, Zhang WY, Ovlyakulov B, Zhang X, Zhu JH. Association Analyses of Autonomic Dysfunction and Sympathetic Skin Response in Motor Subtypes of Parkinson's Disease. Front Neurol. 2020 Nov 3;11:577128. doi: 10.3389/fneur.2020.577128.
26.Kao TY, Chio CC, Lin MT. Hypothalamic dopamine release and local cerebral blood flow during onset of heatstroke in rats. Stroke. 1994 Dec;25(12):2483-6; discussion 2486-7. doi: 10.1161/01.str.25.12.2483.
27.Sarchioto M, Ricchi V, Melis M, Deriu M, Arca R, Melis M, Morgante F, Cossu G. Dyskinesia-Hyperpyrexia Syndrome in Parkinson's Disease: A Heat Shock-Related Emergency? Mov Disord Clin Pract. 2018 Oct 3;5(5):534-537. doi: 10.1002/mdc3.12663.
28.Robottom BJ, Weiner WJ, Factor SA. Movement disorders emergencies. Part 1: Hypokinetic disorders. Arch Neurol. 2011 May;68(5):567-72. doi: 10.1001/archneurol.2011.84.
29.Tousi B. Movement disorder emergencies in the elderly: recognizing and treating an often-iatrogenic problem. Cleve Clin J Med. 2008 Jun;75(6):449-57. doi: 10.3949/ccjm.75.6.449.
30.Vaughan CL, Goldman JG. Psychosis and Parkinson’s disease. In: Frucht SJ, editor. Movement disorder emergencies: Diagnosis and treatment. New York: Humana Press; 2013. pp. 75–92.
31.Kalabalik J, Brunetti L, El Srougy R. Intensive care unit delirium: a review of the literature. J Pharm Pract 2014;27(2):195–207.doi: 10.1177/0897190013513804.
32.Burns A, Gallagley A, Byrne J. Delirium. J Neurol Neurosurg Psychiatry 004;75(3):362–7. doi: 10.1136/jnnp.2003.023366.
33.Vardy ER, Teodorczuk A, Yarnall AJ. Review of delirium in patients with Parkinson’s disease. J Neurol 2015;262(11):2401–10. doi: 10.1007/s00415-015-7760-1.
34.Seppi K, Weintraub D, Coelho M, Perez-Lloret S, Fox SH, Katzenschlager R, et al. The movement disorder society evidence - based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord 2011;26(Suppl 3):S42–80. doi: 10.1002/mds.23884.
35.Hakeem H, Nasir M, Khan MF, Syed NM, Rajput HM, Ahmed A, Javed MA, Bhatti DE. Recognizing Movement Disorder Emergencies - A Practical Review For Non-Neurologist. J Ayub Med Coll Abbottabad. 2019 Jul-Sep;31(3):448-453.
36.Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–922. doi: 10.1016/S0140-6736(13)60688-1.
37.Leroi I, Pantula H, McDonald K, Harbishettar V. Neuropsychiatric symptoms in Parkinson's disease with mild cognitive impairment and dementia. Parkinsons Dis. 2012;2012:308097. doi: 10.1155/2012/308097.
38.Weintraub D, Mamikonyan E. The neuropsychiatry of Parkinson disease: A perfect storm. The American Journal of Geriatric Psychiatry. 2019;27(9):998–1018. doi: 10.1016/j.jagp.2019.03.002.
39.Daniels C, Rodríguez-Antigüedad J, Jentschke E, Kulisevsky J, Volkmann J. Cognitive disorders in advanced Parkinson's disease: challenges in the diagnosis of delirium. Neurol Res Pract. 2024 Mar 14;6(1):14. doi: 10.1186/s42466-024-00309-4.
40.American Psychiatric Association, DSM-5 Task Force . Diagnostic and statistical manual of mental disorders: DSM-5™. 5. American Psychiatric Publishing, Inc.; 2013.
41.Marcantonio ER. Delirium in hospitalized older adults. New England Journal of Medicine. 2017;377(15):1456–1466. doi: 10.1056/NEJMcp1605501.
42.Fong TG, Davis D, Growdon ME, Albuquerque A, Inouye SK. The interface between delirium and dementia in elderly adults. Lancet Neurology. 2015;14(8):823–832. doi: 10.1016/S1474-4422(15)00101-5.
43.Wilson JE, Mart MF, Cunningham C, Shehabi Y, Girard TD, MacLullich AMJ, Ely EW. Delirium. Nature Reviews Disease Primers. 2020;6(1):90. doi: 10.1038/s41572-020-00223-4.
44.Cavallari M, Dai W, Guttmann CR, Meier DS, Ngo LH, Hshieh TT, Group SS. Neural substrates of vulnerability to postsurgical delirium as revealed by presurgical diffusion MRI. Brain. 2016;139(Pt 4):1282–1294. doi: 10.1093/brain/aww010.
45.Shi Q, Warren L, Saposnik G, Macdermid JC. Confusion assessment method: A systematic review and meta-analysis of diagnostic accuracy. Neuropsychiatric Disease and Treatment. 2013;9:1359–1370. doi: 10.2147/NDT.S49520.
46.Cole MG, Ciampi A, Belzile E, Zhong L. Persistent delirium in older hospital patients: A systematic review of frequency and prognosis. Age and Ageing. 2009;38(1):19–26. doi: 10.1093/ageing/afn253.
47.Dasgupta M, Hillier LM. Factors associated with prolonged delirium: A systematic review. International Psychogeriatrics. 2010;22(3):373–394. doi: 10.1017/S1041610209991517.
48.Lawson RA, McDonald C, Burn DJ. Defining delirium in idiopathic Parkinson’s disease: A systematic review. Parkinsonism & Related Disorders. 2019;64:29–39. doi: 10.1016/j.parkreldis.2018.09.025.)
49.Lawson RA, Richardson SJ, Yarnall AJ, Burn DJ, Allan LM. Identifying delirium in Parkinson disease: A pilot study. International Journal of Geriatric Psychiatry. 2020;35(5):547–552. doi: 10.1002/gps.5270.
50.Chang A, Fox SH. Psychosis in Parkinson’s disease: Epidemiology, pathophysiology, and management. Drugs. 2016;76(11):1093–1118. doi: 10.1007/s40265-016-0600-5.
51.Serrano-Dueñas M, Bleda MJ. Delirium in Parkinson’s disease patients. A five-year follow-up study. Parkinsonism & Related Disorders. 2005;11(6):387–392. doi: 10.1016/j.parkreldis.2005.05.002.
52.Li H, Han S, Feng J. Delirium after Deep Brain Stimulation in Parkinson's Disease. Parkinsons Dis. 2021 Feb 1;2021:8885386. doi: 10.1155/2021/8885386.
Published
2025/11/19
Section
Pregledni rad / Review article