疑难帕金森病高热综合征1例报道及临床解析  

Clinical analysis of a difficult case with the Parkinsonism hyperpyrexia syndrome

作　　者：冯欢欢 李立艳 孟庆义 Feng Huan-huan;Li Li-yan;Meng Qing-yi(Emergency Department,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]中国人民解放军总医院第一医学中心急诊科,北京100853 [2]北京市第一中西医结合医院急诊科,北京100020 [3]中国人民解放军总医院海南医院急诊科,海南三亚572013

出　　处：《中国急救医学》2021年第12期1065-1068,共4页Chinese Journal of Critical Care Medicine

摘　　要：帕金森病(Parkinson′s disease,PD)及合并症的治疗过程中存在多重用药现象,由此导致的神经阻滞剂恶性综合征(NMS)、抗帕金森病撤药恶性综合征和5-羟色胺综合征(SS)可交织存在。本文报道1例生前误诊为"脓毒症"的高热、肌强直、自主神经功能障碍、横纹肌溶解及精神异常的PD病例,可能同时存在NMS、抗帕金森病撤药恶性综合征和SS三种危重病综合征,解析其相关病理生理过程,并认为帕金森高热综合征(PHS)的内涵是在PD诊治中以高热为突出表现的病理过程,可涵盖NMS、抗帕金森病撤药恶性综合征和SS的晚期表现,对PD相关危重症的诊治有一定的指导意义。There is a phenomenon of multiple drug use in the treatment of Parkinson′s disease(PD)and its complications.The neuroleptic malignant syndrome(NMS),the withdrawal syndrome of anti-PD drugs,and serotonin syndrome(SS)can coexist.This paper reports a difficult and complicated case with PD misdiagnosed as"sepsis"during his lifetime,its symptom including high fever,myotonia,autonomic nerve dysfunction,rhabdomyolysis and mental disorder.The three kinds of critical illness syndromes(NMS,the withdrawal syndrome of anti-PD drugs,SS)may exist at the same time in this case,and the related pathophysiological processes are analyzed.It is considered that the connotation of Parkinsonism hyperpyrexia syndrome(PHS)is the pathological process with high fever as the prominent manifestation in the diagnosis and treatment of PD,which can cover the manifestations of NMS,the withdrawal syndrome of anti-PD drugs,and SS,which has a certain guiding significance for the diagnosis and treatment of PD-related critical illness.

关 键 词：神经阻滞剂恶性综合征(NMS) 抗帕金森病撤药恶性综合征 5-羟色胺综合征(SS) 帕金森高热综合征(PHS) 疑难病 误诊误治 帕金森病(PD) 

分 类 号：R742.5[医药卫生—神经病学与精神病学]