%0 Journal Article
%A Pötter-Nerger, Monika
%A Schrader, Christoph
%A Jost, Wolfgang H
%A Höglinger, Günter
%T The akinetic crisis in Parkinson's disease - the upper end of a spectrum of subacute akinetic states.
%J Journal of neural transmission
%V 131
%N 10
%@ 0375-9245
%C Wien [u.a.]
%I Springer
%M DZNE-2024-01258
%P 1199 - 1207
%D 2024
%X The akinetic crisis is defined as an acute, potentially life-threatening, levodopa-resistant, severe aggravation of rigidity, severe akinesia, associated with high fever, disturbance of consciousness, dysphagia and autonomic symptoms often due to disruption of dopaminergic medication or infections. The akinetic crisis is a relatively rare event, however subacute mild-moderate motor symptom deterioration in Parkinson´s disease (PD) patients is a frequent cause of hospitalization. In this review, we propose that the akinetic crisis is the upper end of a continuous spectrum of acute akinetic states depending on the degree of the progressive levodopa-resistance. Clinical symptomatology, risk factors, and instrumental diagnostics as the DAT-SPECT reflecting a biomarker of levodopa-resistance will be discussed to evaluate the spectrum of akinetic states. Pathophysiological considerations about the potential role of proinflammatory cytokines on the progressive levodopa-resistance will be discussed and therapeutical, consensus-based guidelines will be presented.
%K Humans
%K Parkinson Disease: drug therapy
%K Parkinson Disease: complications
%K Parkinson Disease: physiopathology
%K Parkinson Disease: diagnosis
%K Antiparkinson Agents: therapeutic use
%K Levodopa
%K Drug Resistance
%K Akinetic crisis (Other)
%K Cytokines (Other)
%K Neuroleptic malignant-like syndrome (Other)
%K Parkinsonism-hyperpyrexia syndrome (Other)
%K Parkinson’s disease (Other)
%K Risk factors (Other)
%K Spectrum acute akinetic states (Other)
%K Therapy (Other)
%K Antiparkinson Agents (NLM Chemicals)
%K Levodopa (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:39153024
%2 pmc:PMC11489269
%R 10.1007/s00702-024-02817-8
%U https://pub.dzne.de/record/272840