| Emergencies in parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-Dopa gel treatment. | |
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MedLine Citation:
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PMID: 20082998 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This article reviews literature on three emergencies in Parkinson's disease (PD): Akinetic crisis, severe dyskinesias or life-threatening dyskinesias, and polyneuropathy during duodenal L-Dopa gel infusion treatment. Akinetic crisis is also known as Parkinsonian hyperpyrexia, Neuroleptic-like malignant syndrome, Acute akinesia, and Malignant syndrome in parkinsonism. It appears in 0.3% of PD patients/year, and is characterized in the most severe cases by total akinesia with dysphagia, hyperthermia, dysautonomia, increment of muscle enzymes and alterations of mental status, but it may also appear in less severe forms ("forme frusta"). At difference with the continuum of motor hypokinesias observed in PD it is characterized by transient (in cases with favorable outcome) unresponsiveness to rescue drugs. Life-supporting measures are mandatory in patients affected by this emergency. Severe dyskinesia, or life-threatening dyskinesia, is due to increased dopaminergic stimulation (either by the patient or by the prescriber): when it appears the level of dopaminomimetic stimulation should be reduced. Polyneuropathy during duodenal L-Dopa gel infusion is a recently described complication, attributed to the onset of Guillain-Barr? syndromes. However, hemapheresis was not effective in some reported cases, and recent evidence suggests that Vitamin B12 deficiency or direct high-dose chronic L-Dopa toxicity might play a role in its origin. |
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Authors:
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Marco Onofrj; Laura Bonanni; Giovanni Cossu; Davide Manca; Fabrizio Stocchi; Astrid Thomas |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Parkinsonism & related disorders Volume: 15 Suppl 3 ISSN: 1873-5126 ISO Abbreviation: Parkinsonism Relat. Disord. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2010-01-19 Completed Date: 2010-03-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9513583 Medline TA: Parkinsonism Relat Disord Country: England |
Other Details:
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Languages: eng Pagination: S233-6 Citation Subset: IM |
Affiliation:
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Institute of Neurology, Movement Disorders Center, Department of Oncology and Neuroscience, University G. D'Annunzio Chieti-Pescara, Italy. onofrj@unich.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antiparkinson Agents
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administration & dosage,
adverse effects* Dyskinesia, Drug-Induced / etiology* Humans Levodopa / administration & dosage, adverse effects* Neuroleptic Malignant Syndrome / etiology* Parkinsonian Disorders / drug therapy* Polyneuropathies / chemically induced* |
| Chemical | |
Reg. No./Substance:
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0/Antiparkinson Agents; 0/Levodopa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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