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Acute akinesia (AA) is a rare but serious complication of Parkinson's Disease (PD) 0,3% of all patients with PD). It can be related to infectious condition, surgery, or treatment changes. AA can completely recover or result in some motor deficits, and, in the most severe forms, it may lead to untreatable complications and death. Here we report the case of a 67-year-old man with PD who rapidly developed a severe akinetic state with rise of temperature (39 degrees C) and creatine phosphokinase concentration (up to 5000 mg/dL). After excluding infection diseases and other pathologies, we suspected AA and added apomorphine 50mg/die s.c. and ondansetron 8 mg i.v. The patient responded to treatment and ameliorated in few weeks.

Memantine protects cultured neurons from excitotoxin-induced cell-death; it attenuated loss of cholinergic neurons in the CNS induced by injection of NMDA into the basal forebrain of rats. It has been shown that memantine induced production of brain-derived neurotrophic factor (BDNF), a substance shown to promote survival and differentiation of CNS neuron. Due to the preclinical effects of memantine owing to its anti-ischemic and anti-excitotoxic properties, recent clinical efficacy has been demonstrated in patients with advanced dementia of vascular origins. Therefore, it has been employed in different trials, in vascular dementia, showing a potential benefit and no unbearable side effects. Different studies underline the possible role of memantine in Parkinson Disease.