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)

More general terms

• syndrome