Reimer Jens, Kuhlmann Anita, Müller Thomas
Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, Germany.
Parkinsonism Relat Disord. 2002 Dec;9(2):115-6. doi: 10.1016/s1353-8020(01)00045-1.
Neuroleptic malignant-like syndrome (NMLS) occurred after rapid switch from bromocriptine to pergolide in a Parkinsonian patient. Although the underlying mechanisms are as yet obscure, we hypothesize that differences in dopamine receptor affinities between bromocriptine and pergolide may be involved. Long-term treatment with bromocriptine may thus have induced plastic changes in intracellular signal processing in the nigrostriatal system, which resulted in reduced dopaminergic efficacy of pergolide. We recommend vigilant outpatient supervision during performance of rapid switchover from one dopamine agonist to another in advanced Parkinson's disease or in subjects with predisposing factors for onset of a neuroleptic malignant syndrome.
一名帕金森病患者在从溴隐亭快速转换为培高利特后出现了类神经安定剂恶性综合征（NMLS）。尽管其潜在机制尚不清楚，但我们推测溴隐亭和培高利特之间多巴胺受体亲和力的差异可能与之有关。因此，长期使用溴隐亭可能在黑质纹状体系统的细胞内信号处理过程中诱导了可塑性变化，从而导致培高利特的多巴胺能效应降低。我们建议，在晚期帕金森病患者或有发生神经安定剂恶性综合征易感因素的患者从一种多巴胺激动剂快速转换为另一种多巴胺激动剂的过程中，要进行密切的门诊监护。
