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Parkinson Disease, Emergency Medicine

Adam Z. Barkin Reviewed 06/2017



  • Gradual progressive neurologic disorder of middle or late life

  • Degeneration of dopaminergic neurons in the substantia nigra

  • Development of Lewy bodies in the residual dopaminergic neur...


Signs and Symptoms

  • Nonmotor vs. motor symptoms:

    • Nonmotor:

      • Orthostatic hypotension

      • Constipation

      • Delayed gastric emptying

      • Dysphagia

      • Pain sensory dysfunction

      • Depression

      • Hallucinations

      • Dementia

      • Sleep disor...


Ed Treatment/Procedures

  • Treatment with antiparkinsonian medications can be initiated in the ED to alleviate symptoms

  • Consultation with neurology for recommended medication regimens and ongoing...



Admission Criteria

  • Patients with previously diagnosed Parkinson with infections, trauma, cardiovascular emergencies, cerebrovascular emergencies, GI emergencies, electrolyte distur...

Pearls and Pitfalls

  • Diagnosis is often difficult; keep in mind other conditions commonly misdiagnosed as PD

  • Sudden withdrawal of dopaminergic medications can result in parkinsonism-hyperpyrexia syndrom...

Additional Reading

  • Chou  KL. In the clinic. Parkinson disease. Ann Intern Med.  2012,157:ITC5-1–ITC5-16.

  • Gazewood  JD, Richards  DR, Clebak  K. Parkinson disease: An update. Am Fam Physician. ...



  • 332.0 Paralysis agitans

  • 332.1 Secondary parkinsonism

  • 333.0 Other degenerative diseases of the basal ganglia

  • 332 Parkinson's disease


  • G20 Parkinson's disease

  • G21.9 Secondary parkinsonism, unsp...

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