It was not just a heatwave! Neuroleptic malignant-like syndrome in a patient with Parkinson's disease

Royal Free Hospital NHS Trust, Pond Street, London NW3, UK.
Age and Ageing (Impact Factor: 3.64). 12/2006; 35(6):640-1. DOI: 10.1093/ageing/afl096
Source: PubMed


Neuroleptic malignant-like syndrome (NMLS) is a rare but life threatening and important complication because of the withdrawal of long-term l-Dopa therapy in Parkinson's disease patients. In this case report, we review the pathophysiology, clinical features and treatment of this curable condition.

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Available from: Jackie Morris, Jan 22, 2015
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    ABSTRACT: 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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