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parkinsonian hyperpyrexia syndrome
Etiology:
- withdrawal of dopaminergic parkinson agent
Clinical manifestations:
- rigidity, dystonia, extrapyramidal symptoms
- pyrexia
- reduced level of consciouness, altered mental status
- variable features
- autonomic instability
- rhabdomyolysis
Laboratory:
- serum creatine kinase may be elevated
Complications:
- acute renal failure
- aspiration pneumonia
- deep venous thrombosis/pulmonary embolism
- disseminated intravascular coagulation (DIC)
- permanent sequelae in 30% of patients
- mortality may be up to 4%
Differential diagnosis:
- malignant hyperthermia
- neuroleptic malignant syndrome
Management:
- supportive therapy
- replacement of dopaminergic agent(s) (Sinemet)
General
syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015
- Newman EJ, Grosset DG, Kennedy PG.
The parkinsonism-hyperpyrexia syndrome.
Neurocrit Care. 2009;10(1):136-40.
PMID: 18712508