Parkinsons disease Akinetic attacks

Acute akinesia is a sudden worsening of Parkinson's disease characterized by immobility lasting several days. It often responds poorly to standard Parkinson's medications and can be lethal. It's important to identify and address underlying causes, such as infection or medication errors, in hospitalized patients.

Overview of Acute Akinesia:

Acute akinesia is a sudden exacerbation of Parkinson disease and is characterized by an akinetic state that lasts for several days. It responds poorly to treatment with antiparkinson medications. This phenomenon may sometimes occur in patients not previously treated with levodopa. It could by lethal in 12% of patients. (1)

Potential Causes and Initial Management:

If patients develop acute akinesia, they should be screened for systemic infection or other concurrent medical problems which could cause a sudden worsening of Parkinson disease. Occasionally, it could be caused by substituting the carbidopa/ levodopa dose of 25/100mg instead of 25/250mg. Also, it occurs when using a dopamine receptor blocking agent, such as, metoclopramide or antipsychotic agents with anti- dopaminergic effect. (1) Treatment requires hospitalization, identify and correct the underlying problem or cause. (1, 2)

References

1-Onofrj M, Thomas A. Acute akinesia in Parkinson disease. Neurology 2005; 64:1162.

2- Kaasinen V, Joutsa J, Noponen T, Päivärinta M: Akinetic Crisis in Parkinson's Disease Is Associated with a Severe Loss of Striatal Dopamine Transporter Function: A Report of Two Cases. Case Rep Neurol. 2014 Sep-Dec; 6(3): 275–280.