Movement disorder emergencies

Neepa Patel MD (Dr. Patel of the University of Texas Southwestern received honorariums as a consultant for USWorldMed.)
Joseph Jankovic MD, editor. (Dr. Jankovic, Director of the Parkinson's Disease Center and Movement Disorders Clinic at Baylor College of Medicine, received research funding from Allergan, Allon, Ceregene, Chelsea, EMD Serono, Impax, Ipsen, Lundbeck, Medtronic, Merz, and Teva, and compensation for his services as a consultant or an advisory committee member by Allergan, Auspex, EMD Serono, Lundbeck, Merz, Neurocrine Biosciences, and Teva.)
Originally released January 6, 2012; last updated December 14, 2015; expires December 14, 2018

This article includes discussion of movement disorder emergencies, neuroleptic malignant syndrome, parkinsonism-hyperpyrexia syndrome, parkinsonism, serotonin syndrome, catatonia, dystonic storm, and Tourette syndrome. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Movement disorders are not commonly associated with rapidly evolving life-threatening clinical syndromes; however, there are several rare syndromes that a neurologist should always consider in the differential diagnosis, such as neuroleptic malignant syndrome, parkinsonism-hyperpyrexia syndrome, acute decompensation of parkinsonism, serotonin syndrome, lethal catatonia, dystonic storm, and malignant Tourette syndrome. Prompt recognition of these syndromes and implementation of the appropriate therapy can reduce morbidity and mortality.

Key points

 

• Movement disorder emergencies are rare disorders, many of which have overlapping clinical features.

 

• Prompt recognition of the correct diagnosis and implementation of the appropriate therapy can reduce morbidity and mortality in the management of movement disorder emergencies.

 

• Discontinuation of the offending treatment strategy and aggressive supportive therapy is the mainstay of treatment in most movement disorder emergencies.

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