Newman et al listed clinical and laboratory findings associated with the Parkinsonism-Hyperpyrexia Syndrome (PHS). These can aid in the early recognition of a potential medical emergency. The authors are from Southern General Hospital in Glasgow.


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.


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