Parkinsonism–hyperpyrexia syndrome not related to antiparkinsonian treatment withdrawal during the 2003 summer heat wave

Gaig, Caries; Martı́, Marı́a José; Tolosa, Eduard; Gómez-Choco, Manuel; Amaro, Sergio

doi:10.1007/s00415-005-0798-8

Cited by 14 publications

(6 citation statements)

References 17 publications

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“…However, in 2005, 3 patients given a diagnosis of advanced Parkinson disease were reported to experience a neuroleptic malignant syndrome during July and August. 3 The maximum mean temperature described then (32.2°C) was similar to our case (Table 1).…”

Section: Discussionsupporting

confidence: 86%

Summertime Dyskinesia-Hyperpyrexia Syndrome: The “Dual Heat” Hypothesis

Herreros-Rodríguez¹,

Sánchez‐Ferro²

2016

Clin Neuropharm

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The dyskinesia-hyperpyrexia syndrome is a rare complication of Parkinson disease. Here, we present an exceptional case affected by this syndrome. Its singularity is 2-fold. On one hand, the patient presented periodic episodes of dyskinesia-hyperpyrexia during 3 consecutive summers. On the other, after unsuccessfully trying several therapies, she had an excellent response to an infusion of enteral L-dopa. Both features allow us to hypothesize that this complication is central in origin and propose a new potential mean of treating future refractory cases.

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Section: Discussionsupporting

confidence: 86%

Summertime Dyskinesia-Hyperpyrexia Syndrome: The “Dual Heat” Hypothesis

Herreros-Rodríguez¹,

Sánchez‐Ferro²

2016

Clin Neuropharm

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“…Additional precipitants reported in the PD patient include co-prescription of neuroleptic medication, dehydration, excessively hot weather, and the wearing-off phenomenon [13,14]. PHS has also been reported in two patients with probable dementia with Lewy bodies (DLB) when commenced on the cholinesterase inhibitor donepezil [15].…”

mentioning

confidence: 99%

The Parkinsonism-Hyperpyrexia Syndrome

2008

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The parkinsonism-hyperpyrexia syndrome (PHS) is a rare but potentially fatal complication seen in Parkinson's disease (PD) patients, most commonly following reduction or cessation of antiparkinson medications. Clinically it resembles neuroleptic malignant syndrome with rigidity, pyrexia, and reduced conscious level. There may be features of autonomic instability, and serum creatine kinase (CK) may be elevated. Complications of PHS include acute renal failure, aspiration pneumonia, deep venous thrombosis/pulmonary embolism, and disseminated intravascular coagulation (DIC). Management consists of dopaminergic drug replacement, supportive measures, and treatment of complications. The prognosis is improved with early recognition and management. Mortality of up to 4% has been reported, but an additional one-third of patients have permanent sequelae. Patients and physicians should be warned against sudden reduction in antiparkinson medications. PHS should always be considered in a patient with parkinsonism who presents with an acute deterioration in symptoms.

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“…Numerous precipitants have been documented, most frequently abrupt withdrawal of dopaminergic medication and infection, as well as failure of deep brain stimulation systems, 1 paralytic ileus and sodium abnormalities. 2 Hot weather has been described as a precipitant, 3 yet patients are not routinely counselled on strategies to mitigate this and is likely an increasing concern given climate change.…”

Section: Discussionmentioning

confidence: 99%

An unwell patient with Parkinson's disease: Hyperpyrexia syndrome in a heatwave

2022

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Summary Hyperpyrexia syndrome in Parkinson's disease (PD) is a medical emergency requiring prompt action. This can be precipitated by numerous provoking factors, in particular withdrawal of dopaminergic medication. We report a case of a patient with PD presenting with confusion, dramatic worsening of PD symptoms and pyrexia in the context of a heatwave, potentially mediating its effect through dehydration and impaired medication absorption. Precipitous cooling and conversion of dopaminergic medication to a rotigotine patch due to drowsiness led to her rapid improvement. The possibility of infection was covered however no source of infection or evidence of inflammatory response was found, but remained an important differential. This case highlights the importance of recognising and managing hyperpyrexia syndrome in PD and the possibility of uncharacteristically hot weather being a cause.

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Parkinsonism–hyperpyrexia syndrome not related to antiparkinsonian treatment withdrawal during the 2003 summer heat wave

Cited by 14 publications

References 17 publications

Summertime Dyskinesia-Hyperpyrexia Syndrome: The “Dual Heat” Hypothesis

Summertime Dyskinesia-Hyperpyrexia Syndrome: The “Dual Heat” Hypothesis

The Parkinsonism-Hyperpyrexia Syndrome

An unwell patient with Parkinson's disease: Hyperpyrexia syndrome in a heatwave

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