Emergencies and critical issues in Parkinson's disease

Pract Neurol. 2020 Feb;20(1):15-25. doi: 10.1136/practneurol-2018-002075. Epub 2019 Aug 19.

Abstract

Complications from Parkinson's disease may develop over the disease course, sometimes unexpectedly, and require prompt or even urgent medical intervention. The most common are associated with aggravation of motor symptoms; serious non-motor complications, such as psychosis, orthostatic hypotension or sleep attacks, also occur. Here we review such complications, their clinical presentation, precipitating factors and management, including those related to using device-aided therapies. Early recognition and prompt attention to these critical situations is challenging, even for the Parkinson's disease specialist, but is essential to prevent serious problems.

Keywords: apomorphine; deep brain stimulation; emergencies; levodopa intestinal gel infusion; parkinson’s disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use*
  • Emergencies
  • Emergency Medical Services / methods*
  • Female
  • Humans
  • Male
  • Malignant Hyperthermia / diagnosis*
  • Malignant Hyperthermia / etiology
  • Malignant Hyperthermia / therapy
  • Parkinson Disease / complications
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / therapy
  • Psychoses, Substance-Induced / diagnosis*
  • Psychoses, Substance-Induced / etiology
  • Psychoses, Substance-Induced / therapy
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / therapy

Substances

  • Antiparkinson Agents