Objective: To describe a case of dyskinesia-hyperpyrexia syndrome (DHS), a rare medical emergency associated with Parkinson’s disease.
Background: DHS is a rare but potentially life-threatening complication of Parkinson’s disease, with approximately 14 cases reported since its first description in 2010. It is typically associated
with excessive dopaminergic stimulation and is characterized by continuous severe dyskinesias accompanied by hyperthermia. Complications such as rhabdomyolysis, acute renal failure, and altered mental status may occur and are associated with poor prognosis.
Method: Retrospective review of the patient’s medical records and relevant literature on DHS.
Results: A 67-year-old patient with a 10-year history of progressive bradykinesia and rigidity was recently diagnosed with Parkinson’s disease. The patient also had a past medical history of
bipolar disorder. Treatment with levodopa/benserazide 100/25 mg twice daily was initiated, resulting in marked improvement without motor fluctuations or dyskinesias.
Thirty days after starting treatment, the patient presented with sudden onset of continuous dyskinesias associated with hyperthermia. On admission, vital signs showed heart rate 160 bpm, respiratory rate 24 breaths/min, blood pressure 180/100 mmHg, and body temperature 39 °C. Investigation revealed that the patient had intentionally ingested
approximately ten times the prescribed dose of levodopa. Laboratory tests showed marked creatine kinase elevation (>5,000 U/L), elevated AST, and leukocytosis. Head CT showed global atrophy, and cerebrospinal fluid analysis was normal. Supportive treatment including intravenous hydration, active cooling, and progressive levodopa reduction led to clinical improvement without major complications.
Conclusion: DHS represents a rare but severe dyskinetic storm related to excessive dopaminergic stimulation. Clinicians should promptly consider exogenous dopaminergic intoxication, particularly in patients with psychiatric comorbidities, as early recognition and supportive management may improve outcomes.
To cite this abstract in AMA style:
T. Coradine, P. Fraiman, D. Salarini, C. Pereira, K. Couto, G. Chung, M. Soares. Hot and Fast but Still Parkinson’s Disease: A Case of Dyskinesia-Hyperpyrexia Syndrome [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/hot-and-fast-but-still-parkinsons-disease-a-case-of-dyskinesia-hyperpyrexia-syndrome/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/hot-and-fast-but-still-parkinsons-disease-a-case-of-dyskinesia-hyperpyrexia-syndrome/