Acute akinesia or akinetic crisis in Parkinson's disease.

In 22 patients with idiopathic Parkinson's disease we observed a sudden worsening of motor symptoms and severe aki- nesia during hospitalization because of infectious diseases, bone fractures, surgery for gastrointestinal tract diseases, and iatrogenic causes. Of these patients, 12 recovered completely, 6 had a partial recovery, and 4 died. Treatments included subcutaneous apomor- phine/lisuride infusion and dantreolene (with a creatine phosphoki- nase level higher than 200 IU). In all patients a definite refractori- ness to therapy was shown with a transient lack of response to apo- morphine.