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Emergencies and critical issues in Parkinson’s disease
  1. Cristina Simonet1,2,
  2. Eduardo Tolosa2,3,
  3. Ana Camara2,
  4. Francesc Valldeoriola2,3
  1. 1 Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, London, UK
  2. 2 Neurology Department, Hospital Clinic de Barcelona, Barcelona, Spain
  3. 3 Neuroscience Department, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
  1. Correspondence to Professor Eduardo Tolosa, Neurology, Hospital Clinic de Barcelona, Barcelona 8036, Spain; etolosa{at}


Complications from Parkinson’s disease may develop over the disease course, sometimes unexpectedly, and require prompt or even urgent medical intervention. The most common are associated with aggravation of motor symptoms; serious non-motor complications, such as psychosis, orthostatic hypotension or sleep attacks, also occur. Here we review such complications, their clinical presentation, precipitating factors and management, including those related to using device-aided therapies. Early recognition and prompt attention to these critical situations is challenging, even for the Parkinson’s disease specialist, but is essential to prevent serious problems.

  • emergencies
  • parkinson’s disease
  • deep brain stimulation
  • levodopa intestinal gel infusion
  • apomorphine

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  • Contributors All the authors contributed to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed by Paul Worth, Cambridge, UK and Simon Lewis, Sydney, Australia

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