Korean J Geriatr Gerontol.  2023 Dec;24(3):127-130. 10.15656/kjcg.2023.24.3.127.

Dyskinesia-Hyperpyrexia Syndrome in Patient with Parkinson’s Disease Mistaken for General Seizure

• Jung DE
• Song IU

• KMID: 2566365
• DOI: http://doi.org/10.15656/kjcg.2023.24.3.127

Abstract

Dyskinesia-hyperpyrexia Syndrome (DHS) is a rare movement disorder emergency associated with Parkinson’s disease (PD), characterized by severe continuous dyskinesia accompanied by high fever and subsequent alterations in mental state. We present the case of a 74-year-old man with a nine-year history of PD who was admitted to the emergency room. He exhibited severe general dyskinesia, including myoclonus and chorea, along with a high fever and a stuporous mental state. Upon initial examination, a general myoclonic seizure associated with high fever was suspected. Consequently, the patient received hydration, antipyretic therapy, and sedative treatment. Upon the recovery of mental status, it was discovered that he had taken a higher dose of dopaminergic medication than usual on the day of his visit, as per his medical history. Subsequently, it was hypothesized that the severe dyskinesia, high fever, and loss of consciousness were related to this increased medication dosage. Therefore, his final diagnosis was DHS in PD. The dosage of dopaminergic medication was adjusted, and re-education was provided to the patient. This case report highlights the importance of recognizing DHS, as this patient was initially misinterpreted as having a generalized seizure due to severe dyskinesia and impaired mental state.

Keyword

Dyskinesias; Hyperthermia; Parkinson Disease; Seizures