{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:42:31Z","timestamp":1781599351508,"version":"3.54.5"},"reference-count":44,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Background: Parkinsonism-hyperpyrexia syndrome (PHS) is a potentially life-threatening condition that occurs due to the abrupt withdrawal or significant dose reduction of antiparkinsonian medications. It presents similarly to neuroleptic malignant syndrome (NMS) and is characterized by severe rigidity, fever, autonomic instability, and altered mental status.<\/jats:p>\n                  <jats:p>Case: A 62-year-old male with a 10-year history of Parkinson\u2019s disease (PD) underwent laparoscopic mesh repair for a left-sided diaphragmatic and large hiatus hernia. His antiparkinsonian medications included levodopa\/carbidopa, amantadine, pramipexole, and benzhexol. Medications were withheld as part of the nil per os (NPO) status. Postoperatively, he developed withdrawal features, including tremors, difficulty speaking, tachycardia, hypertension, fever, and sweating. PHS, resulting from the withdrawal of antiparkinsonian medications, was diagnosed. The patient was transferred to the intensive care unit (ICU), intubated, and his antiparkinsonian medications were reintroduced. The patient\u2019s condition improved gradually, and he was discharged home on the 15th postoperative day.<\/jats:p>\n                  <jats:p>Discussion: The abrupt discontinuation of antiparkinsonian medications precipitated PHS in our patient. Recognizing the clinical picture of PHS and differentiating it from other possible conditions, such as neuroleptic malignant syndrome and malignant hyperthermia, is pivotal. Management involves resuming medications and providing supportive care. Early recognition and prompt reintroduction of the antiparkinsonian medications are essential for the patient\u2019s recovery.<\/jats:p>\n                  <jats:p>Conclusion: PHS is a rare but potentially life-threatening condition that occurs due to the withdrawal of antiparkinsonian medications, leading to an acute hypodopaminergic state. Our case emphasizes the importance of careful perioperative management of antiparkinsonian medications and early recognition and management of withdrawal symptoms in patients with Parkinson\u2019s disease undergoing surgery.<\/jats:p>","DOI":"10.5339\/qmj.2023.34","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:30:30Z","timestamp":1704241830000},"source":"Crossref","is-referenced-by-count":4,"title":["Parkinsonism-Hyperpyrexia Syndrome in a patient undergoing upper gastrointestinal surgery: A case report"],"prefix":"10.5339","volume":"2023","author":[{"given":"Nissar","family":"Shaikh","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Perioperative Care, Hamad Medical Corporation, Doha, Qatar Email: saadeddinmd@gmail.com ORCID iD: 0000-0002-9718-949X"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Saadeddin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care, Hamad Medical Corporation, Doha, Qatar Email: saadeddinmd@gmail.com ORCID iD: 0000-0002-9718-949X"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"key":"CIT0001","series-title":"Front Pharmacol","first-page":"805388","article-title":"Molecular Mechanisms and Therapeutic Strategies for Levodopa-Induced Dyskinesia in Parkinson\u2019s Disease: A Perspective Through Preclinical and Clinical Evidence","volume":"13:","author":"Bandopadhyay R","year":"2022"},{"issue":"(6):","key":"CIT0002","series-title":"JAMA","first-page":"548\u201360","article-title":"Diagnosis and Treatment of Parkinson Disease: A Review","volume":"323","author":"Armstrong MJ","year":"2020"},{"issue":"(4):","key":"CIT0003","series-title":"Indian J Psychiatry","first-page":"499\u2013503","article-title":"Parkinsonism-hyperpyrexia syndrome: A case report and review of literature","volume":"60","author":"Grover 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