Zolpidem withdrawal status dystonicus in the patient with advanced Parkinson's disease

Kojović, Maja; Kramberger, Milica G.

doi:10.1016/j.parkreldis.2015.03.015

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…On the other hand, in some cases the term SD is abused. For instance, SD has been reported in an advanced PD patient after zolpidem withdrawal . This patient presented to the emergency department with tachypnea, difficulties swallowing, and elevated CK, but no dystonia or other hyperkinetic movements, as described in the physical examination and visible in the supplementary video accompanying the case report, possibly pointing toward a diagnosis of akinetic crisis …”

Section: Differential Diagnosismentioning

confidence: 80%

Rethinking status dystonicus

Ruiz-López

Fasano

2017

Movement Disorders

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Status dystonicus is a movement disorder emergency that has been a source of controversy in terms of terminology, phenomenology, and management since it was first described in 1982. Here we argue that the current use of the term status dystonicus falls well short of the precision needed for either clinical or academic use. We performed a critical review on this topic, describing possible pathophysiological mechanisms and areas of uncertainties. This review also addresses the problems derived by the extreme clinical heterogeneity of this condition, as the lack of an objective criterion useful for the definition, or the fact that status dystonicus may present not only in the context of a known dystonic syndrome. We propose a new possible definition that includes not only dystonia but also other hyperkinetic movements in the wide range of movement disorders that can be seen during an episode. The new definition keeps the term status dystonicus and highlights the fact that this is a medical emergency based on the impairment of bulbar and/or respiratory function requiring hospital admission as the principal feature. Furthermore, the new definition should not consider as necessary unspecific features as patient's condition at baseline, the distribution of dystonia, occurrence of systemic symptoms such as fever or laboratory findings. We hope that this proposal will stimulate the debate on this subject among our peers, further developing a clinical and pathophysiological understanding of status dystonicus. © 2017 International Parkinson and Movement Disorder Society.

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Section: Differential Diagnosismentioning

confidence: 80%

Rethinking status dystonicus

Ruiz-López

Fasano

2017

Movement Disorders

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“…Examples of the latter include ITB withdrawal [11, 12], reduction or withdrawal of other dystonia medications or initiation of D-penicillamine in Wilson’s disease [13, 14]. Other examples include introduction of clonazepam (paradoxically it can also be used as treatment of dystonic storm) [1], initiation of zinc in Wilson’s disease [15] or zolpidem discontinuation in Parkinson’s disease [16]. Other provoking factors include surgical procedures and deep brain stimulation (DBS) failure [17, 18].…”

Section: Dystonic Storm: Clinical Featuresmentioning

confidence: 99%

Dystonic storm: a practical clinical and video review

Termsarasab

Frucht

2017

J Clin Mov Disord

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Dystonic storm is a frightening hyperkinetic movement disorder emergency. Marked, rapid exacerbation of dystonia requires prompt intervention and admission to the intensive care unit. Clinical features of dystonic storm include fever, tachycardia, tachypnea, hypertension, sweating and autonomic instability, often progressing to bulbar dysfunction with dysarthria, dysphagia and respiratory failure. It is critical to recognize early and differentiate dystonic storm from other hyperkinetic movement disorder emergencies. Dystonic storm usually occurs in patients with known dystonia, such as DYT1 dystonia, Wilson’s disease and dystonic cerebral palsy. Triggers such as infection or medication adjustment are present in about one-third of all events. Due to the significant morbidity and mortality of this disorder, we propose a management algorithm that divides decision making into two periods: the first 24 h, and the next 2–4 weeks. During the first 24 h, supportive therapy should be initiated, and appropriate patients should be identified early as candidates for pallidal deep brain stimulation or intrathecal baclofen. Management in the next 2–4 weeks aims at symptomatic dystonia control and supportive therapies.Electronic supplementary materialThe online version of this article (doi:10.1186/s40734-017-0057-z) contains supplementary material, which is available to authorized users.

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“…SD can occur not only in patients with previously prominent dystonia, but also in other movement disorders. 18 In patients receiving DBS therapy, battery depletion was the most frequent precipitating factor for SD in both good and poorer responders to DBS. 6,19 The different temporal patterns of evolution to SD (two thirds rapidly developed SD, which is in line with the literature 10,20 ), but also the time frame for a clinical response following therapeutic interventions such as DBS, argue in favor of distinct pathophysiological backgrounds for SD, as has been suggested previously.…”

Section: Discussionmentioning

confidence: 98%

“…SD can occur not only in patients with previously prominent dystonia, but also in other movement disorders . In patients receiving DBS therapy, battery depletion was the most frequent precipitating factor for SD in both good and poorer responders to DBS …”

Section: Discussionmentioning

confidence: 99%