A RARE POSTOPERATIVE NEUROLOGIC CRISIS.
- MS, Senior Resident - Division of Vascular Surgery, Dept. of CVTS, SCTIMST.
- MS, PDCC (Vascular Surgery), FRCS, Additional Professor? Division of Vascular Surgery, Dept. of CVTS, SCTIMST.
- MS, MCh (Vascular Surgery), Assistant Professor ? Division of Vascular Surgery, Dept. of CVTS, SCTIMST.
- MS, MRCSEd, Senior Resident, MCh Vascular Surgery- Division of Vascular Surgery, Dept. of CVTS, SCTIMST.
- Cite This Article as
- Corresponding Author
Ischaemic myelopathy is one of the causes of limb weakness following open repair of aortic aneurysm. We present the case report of a 73 year old male, who was on treatment for Parkinsonism and became immobile after aortic surgery for ruptured infrarenal abdominal aortic aneurysm. Initially, ischaemic myelopathy was suspected, but it ultimately turned out to be acute presentation of akinetic crisis, which is a rare complication of Parkinson\'s disease. It is a preventable complication, as it most often occurs due to the inadvertent withdrawal of antiparkinsonian medications, as in our patient. Hence, it is important, especially for a vascular surgeon performing surgery for abdominal aortic aneurysm, to be aware of this condition for prompt diagnosis and treatment without which the condition causes serious morbidity and even mortality.
- Magrinelli F, Picelli A, Tocco P, Federico A et al. Pathophysiology of Motor Dysfunction in Parkinson?s Disease as the Rationale for Drug Treatment and Rehabilitation. 2016 Park Dis [Internet].
- Onofrj M, Bonanni L, Cossu G, Manca D et al. Emergencies in Parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-Dopa gel treatment. Parkinsonism RelatDisord. 2009 Dec 1;15:S233?6.
- Onofrj M, Thomas A. Acute akinesia in Parkinson disease. Neurology. 2005 Apr 12;64(7):1162?9.
- Toru M, Matsuda O, Makiguchi K, Sugano K. Neuroleptic malignant syndrome-like state following a withdrawal of antiparkinsonian drugs. J NervMent Dis. 1981 May;169(5):324?7.
- Kaasinen V, Joutsa J, Noponen T, P?iv?rinta M. Akinetic Crisis in Parkinson?s Disease Is Associated with a Severe Loss of Striatal Dopamine Transporter Function: A Report of Two Cases. Case Rep Neurol. 2014 Nov 26;6(3):275?80.
- Thomas A, Iacono D, Luciano AL, Armellino K. Acute akinesia or akinetic crisis in Parkinson?s disease. Neurol Sci. 2003 Oct 1;24(3):219?20.
- Takubo H, Harada T, Hashimoto T, Inaba Y, et al. A collaborative study on the malignant syndrome in Parkinson?s disease and related disorders. Parkinsonism RelatDisord. 2003 Apr;9 Suppl 1:S31-41.
- Friedman JH, Feinberg SS, Feldman RG. A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal. JAMA. 1985 Nov 15;254(19):2792?5.
- Thomas A, Onofrj M. Akinetic crisis, acute akinesia, neuroleptic malignant-like syndrome, Parkinsonism-hyperpyrexia syndrome, and malignant syndrome are the same entity and are often independent of treatment withdrawal. MovDisord Off J MovDisord Soc. 2005 Dec;20(12):1671-72.
- Rosenthal D, Southern Association for Vascular Surgery. Spinal cord ischemia after abdominal aortic operation: Is it preventable? J Vasc Surg. 1999 Sep 1;30(3):391?9.
[Afshan Punnepillil Thaha, Sreekumar Ramachandran, ShivanesanPitchai and Harishankar Ramachandran Nair. (2018); A RARE POSTOPERATIVE NEUROLOGIC CRISIS. Int. J. of Adv. Res. 6 (12). 252-254] (ISSN 2320-5407). www.journalijar.com
Division of Vascular Surgery- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum
Article DOI: 10.21474/IJAR01/8136 DOI URL: http://dx.doi.org/10.21474/IJAR01/8136
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