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【案例報告】巴金森氏病患者之惡性症候群:案例報告
Malignant Syndrome in Parkinson's Disease Patient: A Case Report
巴金森氏病、惡性症候群、左多巴、 parkinson's disease, malignant syndrome, levodopa
廖芬芬Fen-Fen Liao
1高雄醫學大學附設中和紀念醫院 藥劑部
抗精神藥物惡性症候群(neuroleptic malignant syndrome, NMS)為抗精神藥物所引起嚴重而且可能會致死的併發症。類似的症狀也曾經在巴金森氏病(parkinson's disease, PD)患者長期使用levodopa、dopamine作用劑,以及其它類型抗巴金森藥物,突然停藥或劑量降低的情況下發生。
本案例敘述一位80歲男性PD病患,因症狀惡化且持續高燒、血清肌酸磷酸激 增加以及腎功能急遽惡化,疑似為抗精神藥物惡性症候群。經由重新投予levodopa和支持性療法後,病患退燒、血清肌酸磷酸激 值降至正常範圍、腎功能恢復至住院前的狀態,四肢僵硬程度改善,且沒有震顫出現。
Neuroleptic malignant syndrome is a serious and potentially lethal complication of the use of antipsychotic drugs. Similar symptoms had also been found in parkinson’s disease patient, who treated with levodopa, dopamine agonists and other antiparkinsonia drugs over a long period of time, abrupt withdrawal of drugs or decreasing dosages. 
We reported a clinical case of patient with parkinson’s disease who developed neuroleptic malignant syndrome-like symptoms including worsening parkinson’s disease, sustained high fever, marked elevation of serum creatine phosphokinase, and renal function deterioration. After resumed levodopa and supportive treatments, the patient showed clinical improvement consisting of fever subsided, decline in serum creatine phosphokinase, recovery renal function, and relief of extremities rigidity, with resolution of his tremor.
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