Acute akinesia in PD

 Case: 72 years old male with long history of Parkinson's Disease (PD) is admitted to ICU with acute akinesia.

Discussion: Acute akinesia can be fatal in patients with PD, and should be managed by experienced hands. This is different from the "freezing of Gait" (FOG) phenomenon. It is a sudden exacerbation of PD. Patient stays in an akinetic state for days and unfortunately is not very responsive to antiparkinsonian meds. 

The two major causes are underlying infection/sepsis and manipulation/error of antiparkinsonian drugs. A potential cause particularly in hospitalized patients is the administration of a dopamine receptor blocker or an antipsychotic drug with dopamine blocking properties. 

It should be watched closely in PD patients after surgeries. Diarrhea can also cause acute akinesia.

#neurology

Reference:

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