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Background: Cardiovascular autonomic dysfunction is one of the most frequent non-motor symptoms in idiopathic Parkinson disease (IPD). Several cardiovascular autonomic indexes (CAIs) have been reported to represent the degree of autonomic dysfunction in various neurodegenerative diseases. However, quantitative assessment by autonomic function tests in IPD has not been fully evaluated yet. The aim of this study is to investigate the usefulness of the quantitative autonomic test for detecting subclinical cardiovascular autonomic dysfunction and their correlation to the clinical severity of motor symptoms in IPD. Methods: Four parasympathetic and sympathetic indexes during cardiovascular autonomic tests were compared between patients with IPD (n=31, age=65.8±9.14, Hoen&Yahr (H&Y) stage=2.1±0.68) and age matched healthy controls (n=30, age=63.2±7.56). Parasympathetic indexes include expiration:inspiration ratio (E:I ratio), valsalva ratio, 30:15 ratio, and vagal barosensitivity. Sympathetic indexes are pressure recovery time, sympathetic index 1, sympathetic index 3 and adrenergic baroseneitivity. To demonstrate the correlation between severity of clinical motor symptoms and the autonomic abnormality, we also compared the H&Y stage and the abnormalities of those CAIs. Results: E:I ratio (p=0.009) and Valsalva ratio (VR) (p

Received July 7, 2015 Revised September 14, 2015 Accepted September 14, 2015 Address for correspondence: Jeong-Ho Park, MD, PhD Department of Neurology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea Tel: +82-32-621-5231 Fax: +82-32-621-5056 E-mail: parkgene@schmc.ac.kr 통증긴장연축(painful tonic spasms)은 통증을 동반한 일측성, 혹은 양측성 불수의근긴장이상자세(dystonic posturing)를 보이 는 드문 발작성이상운동증으로 주로 시신경척수염 또는 다발 경화증의 급성기 이후 이들 질환의 경과 중 동반되는 증상이다.

Background: The parkinsonism hyperpyrexia syndrome (PHS) is a rare but potentially fatal disorder. We reported an advanced Parkinson’s disease (PD) patient who was initially diagnosed with fever of unknown origin and finally with PHS, together with a review of the literature. Case Report: A 67-year-old woman with PD presented with high-grade fever accompanied by altered consciousness and rigidity. Prior to the symptom onset, she had a couple week’s history of poor feeding due to her dental problem. However, she had regularly taken her anti-Parkinsonian medication even during that period, which hampered early recognition of PHS at the emergency room. Her anti-Parkinsonian medication was withheld for more than 30 hours during her stay in our emergency room and extensive diagnostic work-up to identify the fever focus. Her neurologic symptoms deteriorated with concurrent acute hepatic failure and disseminated intravascular coagulopathy. Levodopa treatment was resumed on correction of underlying medical conditions. The patient recovered dramatically with normalization of laboratory tests. Conclusion: This case indicated that PHS could occur in patients without prior history of withdrawal of antiparkinsonian medication, possibly due to poor absorption or poor feeding conditions.