Acute and Critical Care

Neurology
Malignant Syndrome in Parkinson Disease Similar to Severe Infection: Dong Hun Lee, Jeong Mi Moon, Yong Soo Cho; Korean J Crit Care Med. 2017;32(4):359-362. Published online December 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00087

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A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40°C) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.

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Parkinsonism-Hyperpyrexia Syndrome and Dyskinesia-Hyperpyrexia Syndrome in Parkinson’s Disease: Two Cases and Literature Review
Jian-Yong Wang, Jie-Fan Huang, Shi-Guo Zhu, Shi-Shi Huang, Rong-Pei Liu, Bei-Lei Hu, Jian-Hong Zhu, Xiong Zhang
Journal of Parkinson's Disease.2022; 12(6): 1727. CrossRef

Neurology
Clozapine Induced Neuroleptic Malignant Syndrome: Yong Suk Jo, Hyung Ah Jo, Byung Chul Yu, Jung Hoon Shin, Kook-Hwan Oh; Korean J Crit Care Med. 2017;32(3):291-294. Published online December 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00052

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Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.

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Toxicity and Adverse Effects in Clozapine-Related Presentations to a Medical Toxicology Service in Western Sydney
Pramod Chandru, Naren Gunja
Journal of Medical Toxicology.2023; 19(4): 374. CrossRef

Neurology
Malignant Neuroleptic Syndrome following Deep Brain Stimulation Surgery of Globus Pallidus Pars Internus in Cerebral Palsy: Jae Meen Lee, Sun Ha Paek, Hye Ran Park, Kang Hee Lee, Chae Won Shin, Hye Young Park, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon; Korean J Crit Care Med. 2016;31(1):34-38. Published online February 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.1.34

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Abstract PDF

Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS) surgery in a cerebral palsy (CP) patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity, and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired, despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after DBS surgery, irrespective of continued dopaminergic medication.

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Metal-free carboxyl modified g-C3N4 for enhancing photocatalytic degradation activity of organic pollutants through peroxymonosulfate activation in wastewater under solar radiation
Xueting Mei, Shujun Chen, Gangqiang Wang, Wenxing Chen, Wangyang Lu, Bingying Zhang, Yu Fang, Chenxiao Qi
Journal of Solid State Chemistry.2022; 310: 123053. CrossRef

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