Prevention and treatment of malignant syndrome in Parkinson's disease: a consensus statement of the malignant syndrome research group.
We report a consensus statement of the collaborative research group on the prevention and treatment of malignant syndrome (MS) in Parkinson's disease. The syndrome is quite similar to neuroleptic MS. Although sudden withdrawal of levodopa was the most frequent cause, many other precipitating events were found such as intercurrent infections, dehydration, hot weather, discontinuation of other anti-parkinsonian drugs, and "wearing off" phenomenon. Awareness of this syndrome is most important for its early detection and the prompt commencement of treatment. MS should be suspected whenever the body temperature rises above 38 degrees C without an apparent cause. Treatment consists of ample intravenous fluid, cooling the body, anti-parkinsonian drugs (particularly levodopa and bromocriptine), dantrolene sodium, and antibiotics if infection is present. Rhabdomyolysis, disseminated intravascular coagulation, and acute renal failure constitute serious complications.
Ikebe
Shin-ichiro
S
Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan.
Harada
Toshiaki
T
Hashimoto
Takao
T
Kanazawa
Ichiro
I
Kuno
Sadako
S
Mizuno
Yoshikuni
Y
Mizuta
Eiji
E
Murata
Miho
M
Nagatsu
Toshiharu
T
Nakamura
Shigenobu
S
Takubo
Hideki
H
Yanagisawa
Nobuo
N
Narabayashi
Hirotaro
H
D000978:Antiparkinson Agents / Q000009:adverse effects*; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D010300:Parkinson Disease / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome
D000978:Antiparkinson Agents