What can cause sudden onset parkinsonism symptoms?

From the Guidelines

Sudden onset parkinsonism symptoms can be caused by various factors, including genetic conditions such as 22q11.2 deletion syndrome, which may lead to an increased risk of developing Parkinson's disease, particularly early-onset PD, as well as other movement disorders like dystonia and functional neurologic disorders. According to a recent study published in 2023 in the journal Genetics in Medicine 1, adults with 22q11.2DS have a higher risk of developing Parkinson's disease and other movement disorders. Some key points to consider include:

• Increased risk of Parkinson's disease, particularly early-onset PD, in adults with 22q11.2DS
• Other movement disorders like dystonia, functional neurologic disorders, myoclonus, motor tics, restless legs, postural and action tremors, and drug-induced movement disorders may also be more common in adults with 22q11.2DS
• Hypocalcemia may induce or worsen movement disorders, highlighting the importance of managing underlying conditions
• Periodic neurologic enquiry/assessments and standardized rating scales can help ensure prompt diagnosis and treatment of seizures and movement disorders in adults with 22q11.2DS. When diagnosing and treating sudden onset parkinsonism symptoms, it is essential to consider the possibility of underlying genetic conditions like 22q11.2DS and to collaborate with specialists, such as movement disorders neurologists, to provide optimal care.

From the FDA Drug Label

ADVERSE REACTIONS CNS Effects: Extrapyramidal Symptoms (EPS) – EPS during the administration of Haloperidol have been reported frequently, often during the first few days of treatment. EPS can be categorized generally as Parkinson-like symptoms, akathisia, or dystonia Dystonia Class effect: Symptoms of dystonia, prolonged abnormal contractions of muscle groups, may occur in susceptible individuals during the first few days of treatment.

• Sudden onset parkinsonism symptoms can be caused by:
  • Extrapyramidal Symptoms (EPS) associated with the administration of haloperidol, which can occur frequently, often during the first few days of treatment.
  • Dystonia, which can occur in susceptible individuals during the first few days of treatment. 2 2

From the Research

Causes of Sudden Onset Parkinsonism Symptoms

Sudden onset parkinsonism symptoms can be caused by various factors, including:

• Drug-induced parkinsonism: certain medications such as dopamine blocking drugs, dopamine depleting drugs, and calcium channel blockers can cause parkinsonism symptoms 3
• Toxins: exposure to toxins like manganese, carbon monoxide, or MPTP can also lead to parkinsonism symptoms 3
• Antipsychotic-induced parkinsonism: the use of antipsychotic drugs, particularly typical antipsychotics, can cause parkinsonism symptoms as a side effect 4, 5
• Other medications: certain medications like fluoxetine, lithium, and amiodarone may also contribute to the development of parkinsonism symptoms 3

Management of Sudden Onset Parkinsonism Symptoms

The management of sudden onset parkinsonism symptoms depends on the underlying cause:

• If drug-induced, reducing the dosage or switching to a different medication may help alleviate symptoms 4, 5
• Anticholinergic agents or amantadine may be used to treat antipsychotic-induced parkinsonism 4, 5
• In cases where antipsychotic drugs are necessary, atypical antipsychotics like clozapine or olanzapine may be considered, as they have a lower risk of causing parkinsonism symptoms 6, 7