Emergencies in parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-Dopa gel treatment

Why is there motor deterioration in Parkinson’s disease during systemic infections-a hypothetical view

“…In a retrospective analysis of 675 patients by Onofrj and Thomas, 4 26 patients had developed acute akinesia. In 17 of them, infections were identified as the precipitating factor.…”

“…Patients then often become unresponsive to antiparkinsonian drugs. 4 Infections are furthermore often accompanied by delirium, in PD frequently presenting in its’ hypoactive form. 5 Although the diagnosis of delirium defined as an acute organic brain disorder with cognitive impairment, attention disorders, reduced level of consciousness, altered psychomotor activity, and wake–sleep rhythm disorders does not necessarily require the presence of motor symptoms, its occurrence is a risk factor for both long-term motor and cognitive deterioration in PD.…”

Advances in Drug Therapy: Alternative Treatments for the Control of Motor Fluctuations and Dyskinesias

“…Adverse effects in relation to Duodopa (drowsiness, visual hallucinations, psychotic episodes, dizziness, headache) are similar to those seen with conventional levodopa (Nyholm et al, 2005). There have been case reports of polyneuropathy of the Guillain Barre type (Antonini et al, 2007) and development of vitamin B12 and B6 deficiency polyneuropathy (Onofrj et al, 2009). …”

Peripheral nervous system involvement in Parkinson's disease: Evidence and controversies

“…Although VB12 administration may provide benefit in some cases, supplementation as a preventive treatment is questionable [28,35,41,42].…”