Kataoka Hiroshi, Eura Nobuyuki, Kiriyama Takao, Uchihara Yuto, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara, Nara, Japan.
Oxf Med Case Reports. 2018 Oct 31;2018(11):omy089. doi: 10.1093/omcr/omy089. eCollection 2018 Nov.
We describe two patients with Parkinson's disease who presented with accidental hypothermia and review seven patients to delineate the characteristics of hypothermia. All cases of hypothermia occurred in the winter. As clinical symptoms preceding the onset of hypothermia, deterioration of bradykinesia or limb coldness was evident. Most cases of hypothermia were accompanied by impaired consciousness and deterioration of parkinsonian features. After warming the body, the hypothermia improved in a relatively short period. Levodopa, dopamine agonists or anticholinergic agents were given to five patients, three patients and three patients, respectively. Bradykinesia developed in most patients a short time before the onset of hypothermia. In various neurological diseases, deterioration of the disease can occur on the background of metabolic/electrolyte disturbance. However, the fact that the bradykinesia developed a short time prior to the onset of hypothermia warrants close observation for signs of temperature dysregulation in patients with substantial neurologic deterioration, especially in the winter.
我们描述了两名患有帕金森病且出现意外体温过低的患者,并回顾了另外七名患者以明确体温过低的特征。所有体温过低的病例均发生在冬季。作为体温过低发作前的临床症状,运动迟缓恶化或肢体发冷很明显。大多数体温过低病例伴有意识障碍和帕金森病特征的恶化。身体复温后,体温过低在相对较短的时间内得到改善。分别有五名、三名和三名患者接受了左旋多巴、多巴胺激动剂或抗胆碱能药物治疗。大多数患者在体温过低发作前短时间内出现运动迟缓。在各种神经系统疾病中,疾病的恶化可能发生在代谢/电解质紊乱的背景下。然而,运动迟缓在体温过低发作前短时间内出现这一事实,值得对神经功能严重恶化的患者,尤其是在冬季,密切观察体温调节异常的迹象。