CAUSES OF SUDDEN WORSENING IN PARKINSON'S DISEASE

Neurologist [2012] 18 (3) : 120-124 (K.S..Zheng, B.J.Dorfman, P.J.Christos,
N.R.Khadem, C.Henchcliffe, P. Piboolnurak, M.J.Nirenberg) Complete abstract

Episodes of sudden and transient worsening of symptoms commonly occur in
Parkinson's Disease, especially when the Parkinson's Disease is more severe. A
quarter of people with Parkinson's Disease were found to be affected in this
way. Infection was the single most frequent cause, accounting for a quarter of
cases. Other common causes were anxiety, medication errors, poor adherence to
taking the required drugs, medication side effects, and postoperative decline.
Overall, over 80% of reasons were attributable to reversible or treatable
causes.
Most people who experienced a sudden worsening of symptoms recovered fully,
but a third of people experienced recurrent episodes. One in six people
suffered permanent decline. Those people most prone to sudden or transient
worsening were those who had Parkinson's Disease for nearly eight years or
more, had more severe symptoms, had greater use of dopaminergic drugs, and had
a greater prevalence of motor complications.

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