Neurológia pre prax 6/2009

Acute conditions with extrapyramidal symptoms

A movement disorder emergency (MDE) is an acute or subacute state, in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality. The syndromes are most frequently caused by certain drugs administration, or conversely their withdrawal, but the etiology may also include infections, toxins, focal brain lesions, metabolic disturbances, or autoimmune disorders. MDEs are frequent in patients with Parkinson’s disease. With respect to differential diagnosis, psychogenic movement disorder or psychiatric etiology of an acute state should be considered. Further in the text, serotonine syndrome, neuroleptic malignant syndrome, parkinsonism-hyperpyrexia syndrome, status dystonicus, and acute hemichorea-hemibalism with be described in more details.

Keywords: movement disorder emergency, Parkinson’s disease, serotonine syndrome, neuroleptic malignant syndrome, parkinsonismhyperpyrexia syndrome, status dystonicus, acute hemichorea-hemibalism.