Emergency department presentations of patients with Parkinson's disease

Am J Emerg Med. 2000 Mar;18(2):209-15. doi: 10.1016/s0735-6757(00)90023-8.


Parkinson's disease (PD) is a chronic progressive neurological disorder characterized by tremor, muscle rigidity, slowness of movement (bradykinesia), and gait instability. In early disease, PD is well managed in an office setting, however, as the disease progresses, a variety of syndromes may result in emergency department visits. The scenarios most likely to require an emergent evaluation are severe motor "off" periods with immobility, involuntary movements (dyskinesia), psychosis, acute confusion, panic disorder, and pain. Other less frequent presentations are also discussed. This article uses illustrative cases to provide a framework to discuss emergency department diagnosis and management issues in caring for these patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Confusion / etiology*
  • Disease Progression
  • Dyskinesias / etiology*
  • Emergency Treatment / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurocognitive Disorders / etiology*
  • Pain / etiology*
  • Parkinson Disease / complications*
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / psychology
  • Parkinson Disease / therapy
  • Restless Legs Syndrome / etiology*