Neuroleptic malignant syndrome-like, or--dopaminergic malignant syndrome--due to levodopa therapy withdrawal. Clinical features in 11 patients

Parkinsonism Relat Disord. 2003 Jan;9(3):175-8. doi: 10.1016/s1353-8020(02)00035-4.

Abstract

A clinical picture named neuroleptic malignant-like syndrome has been described in patients with Parkinson's disease (PD) who suddenly stop their L-dopa treatment. The sudden withdrawal of the drug is deemed to lead to an acute deficiency stage in a patient who has an iatrogenic increase of dopaminergic transmission. We present a series of 11 patients with PD with an average age of 72.09 years, a mean disease duration of 9.45 years who developed this problem after a 92.72 h latency period. If patients with PD develop severe rigidity, stupor and hyperthermia, L-dopa withdrawal should be suspected and the dopaminergic drug restarted as soon as possible.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Diagnosis, Differential
  • Female
  • Humans
  • Levodopa / adverse effects*
  • Male
  • Middle Aged
  • Neuroleptic Malignant Syndrome / diagnosis*
  • Neuroleptic Malignant Syndrome / drug therapy
  • Neuroleptic Malignant Syndrome / physiopathology
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / physiopathology

Substances

  • Levodopa