Y Sato1, T Asoh, N Metoki, K Satoh. 1. Department of Neurology, Futase Social Insurance Hospital, Iizuka 820-0054, Japan. noukenrs@cc.hirosaki-u.ac.jp
Abstract
BACKGROUND:Neuroleptic malignant syndrome (NMS) is a dangerous complication in patients with Parkinson's disease (PD). AIMS: To evaluate the efficacy of methylprednisolone pulse therapy compared to placebo in PD patients with NMS. METHODS: In a double blind, placebo controlled study, 20 PD patients with NMS receivedsteroid pulse therapy for three days, and 20 PD patients received placebo. Both groups received levodopa, bromocriptine, and dantrolene. RESULTS:NMS in the steroid group healed within 10 days in 17 patients; median value of duration of illness of NMS in this group was 7 days (range 4-20). NMS in the placebo group healed within 10 days in five patients; in the remaining 15, it persisted for 12-27 days after the onset of NMS; median value of duration illness of NMS in this group was 18 days. Hyperthermia, rigidity, and consciousness improved within 10 days in many patients in the steroid group; these signs persisted more than 10 days in many patients in the placebo group. CONCLUSIONS:Steroid pulse therapy is useful in NMS for reducing the illness duration and improving symptoms.
RCT Entities:
BACKGROUND:Neuroleptic malignant syndrome (NMS) is a dangerous complication in patients with Parkinson's disease (PD). AIMS: To evaluate the efficacy of methylprednisolone pulse therapy compared to placebo in PDpatients with NMS. METHODS: In a double blind, placebo controlled study, 20 PDpatients with NMS received steroid pulse therapy for three days, and 20 PDpatients received placebo. Both groups received levodopa, bromocriptine, and dantrolene. RESULTS:NMS in the steroid group healed within 10 days in 17 patients; median value of duration of illness of NMS in this group was 7 days (range 4-20). NMS in the placebo group healed within 10 days in five patients; in the remaining 15, it persisted for 12-27 days after the onset of NMS; median value of duration illness of NMS in this group was 18 days. Hyperthermia, rigidity, and consciousness improved within 10 days in many patients in the steroid group; these signs persisted more than 10 days in many patients in the placebo group. CONCLUSIONS:Steroid pulse therapy is useful in NMS for reducing the illness duration and improving symptoms.
Authors: Margherita Capasso; Maria Vittoria De Angelis; Antonio Di Muzio; Francesca Anzellotti; Laura Bonanni; Astrid Thomas; Marco Onofrj Journal: Medicine (Baltimore) Date: 2015-07 Impact factor: 1.889