skip to main content

Parkinsonism-hyperpyrexia syndrome — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardMedicine in the ElderlyParkinsonism-hyperpyrexia syndromeSCE Acute Medicine

A 78-year-old man with Parkinson's disease is admitted from a care home with rigidity, fever and confusion. His co-careldopa was omitted for 36 hours because he was nil by mouth. Creatine kinase is 2,900 IU/L and infection screen is unrevealing. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Restart dopaminergic treatment through an available route

Abrupt withdrawal of dopaminergic medication can cause parkinsonism–hyperpyrexia syndrome with rigidity, fever, confusion and raised CK. Reinstate dopaminergic therapy urgently by a suitable enteral or transdermal bridging route, provide fluids and cooling, treat complications and seek Parkinson specialist advice. Dopamine-blocking antipsychotics can worsen the syndrome.

Reference: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations