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Review
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}clinic.ub.es

Abstract

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
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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http://dx.doi.org/10.1136/practneurol-2018-002075

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    Footnotes

    • 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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    © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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