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Published in: Clinical Autonomic Research 4/2021

01-08-2021 | Tachyarrythmia | Review Article

Dyskinesia-hyperpyrexia syndrome in Parkinson’s disease: a systematic review

Authors: Miao Wang, Wei Wang, Zhongbao Gao, Xi Yin, Tong Chen, Ziying Jiang, Zhenfu Wang

Published in: Clinical Autonomic Research | Issue 4/2021

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Abstract

Purpose

Dyskinesia-hyperpyrexia syndrome (DHS) is a rare but life-threatening disease. The clinical manifestations of this syndrome overlap substantially with Parkinson hyperpyrexia syndrome and serotonin syndrome and are often confused by clinicians. The purpose of this review was to enable clinicians to recognize this syndrome and thereby reach a correct diagnosis and provide optimal treatments to improve prognosis in clinical practice.

Methods

Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a literature search of the PubMed, Embase, and MEDLINE databases using keywords in titles and abstracts of published literature. Quality assessment was performed using the modified Newcastle-Ottawa scale.

Results

A total of 11 patients obtained from nine publications were included in this systematic review. All of the cases occurred in patients with advanced Parkinson's disease (PD) of long disease duration. High ambient temperature was the most common trigger of this syndrome. Hyperpyrexia and dyskinesias were present in all cases. The consciousness disturbances of this syndrome included confusion, hallucination, and lethargy or stupor. Autonomic dysfunction (except for hyperpyrexia) is uncommon in DHS, and only two patients presented with tachycardia. The treatment of this syndrome included supportive interventions (including rehydration, anti-pyretic and anti-infection treatments, and maintaining electrolyte balance), dopaminergic drug reduction and sedation. Two patients died due to DHS.

Conclusions

We summarized the triggers, clinical features, and treatments of all reported dyskinesia-hyperpyrexia syndrome cases, proposed guiding diagnostic criteria, and established a flow chart to guide diagnoses to quickly identify these three syndromes in clinical practice.
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Literature
Metadata
Title
Dyskinesia-hyperpyrexia syndrome in Parkinson’s disease: a systematic review
Authors
Miao Wang
Wei Wang
Zhongbao Gao
Xi Yin
Tong Chen
Ziying Jiang
Zhenfu Wang
Publication date
01-08-2021
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 4/2021
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-021-00801-w

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