Patient selection: Parkinson’s disease
Clinical findings:
(1) muscle rigidity with or without tremor
(2) fever with body temperature > 38°C
(3) altered level of consciousness (ranging from confusion to stupor to coma)
(4) dysarthria
(5) dysphagia
(6) autonomic instability
(6a) labile blood pressure
(6b) tachycardia
(6c) diaphoresis (sweating)
(6d) urinary incontinence
(7) variable respiratory depression
Laboratory findings:
(1) elevated serum creatinine kinase (CK), which may be marked
(2) leukocytosis
(3) abnormal liver function tests
(4) metabolic acidosis
Complications may include:
(1) aspiration pneumonia
(2) rhabdomyolysis
(3) acute renal failure
(4) deep vein thrombosis (DVT) with or without pulmonary embolism
(5) disseminated intravascular coagulation (DIC)
(6) malignant hyperthermia
The possibility of PHS should be considered in a patient with Parkinson’s disease who shows an acute deterioration.
