TY  - JOUR
AU  - Pötter-Nerger, Monika
AU  - Schrader, Christoph
AU  - Jost, Wolfgang H
AU  - Höglinger, Günter
TI  - The akinetic crisis in Parkinson's disease - the upper end of a spectrum of subacute akinetic states.
JO  - Journal of neural transmission
VL  - 131
IS  - 10
SN  - 0375-9245
CY  - Wien [u.a.]
PB  - Springer
M1  - DZNE-2024-01258
SP  - 1199 - 1207
PY  - 2024
AB  - 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.
KW  - Humans
KW  - Parkinson Disease: drug therapy
KW  - Parkinson Disease: complications
KW  - Parkinson Disease: physiopathology
KW  - Parkinson Disease: diagnosis
KW  - Antiparkinson Agents: therapeutic use
KW  - Levodopa
KW  - Drug Resistance
KW  - Akinetic crisis (Other)
KW  - Cytokines (Other)
KW  - Neuroleptic malignant-like syndrome (Other)
KW  - Parkinsonism-hyperpyrexia syndrome (Other)
KW  - Parkinson’s disease (Other)
KW  - Risk factors (Other)
KW  - Spectrum acute akinetic states (Other)
KW  - Therapy (Other)
KW  - Antiparkinson Agents (NLM Chemicals)
KW  - Levodopa (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:39153024
C2  - pmc:PMC11489269
DO  - DOI:10.1007/s00702-024-02817-8
UR  - https://pub.dzne.de/record/272840
ER  -