May 31, 2026Journal of the Neurological Sciences2 citationsOpen Access
Acute akinetic collapse in Parkinson's disease: A retrospective study of sustained immobilization and clinical outcomes
Key Result
Acute sustained immobilization in Parkinson's disease significantly worsened functional status, increasing modified Rankin Scale scores from 2.5 to 3.2 (p<0.001).
Key Points
- This study aims to characterize the clinical features and outcomes of acute sustained immobilization in Parkinson's disease requiring hospitalization.
- Conducted a retrospective observational study of PD patients with immobilization lasting ≥12 hours.
- Analyzed clinical characteristics, precipitating factors, laboratory findings, and outcomes.
- Included 40 patients, with a focus on alerts at admission and absence of hyperthermia.
- Falls were the most common triggering event, affecting 45% of the patients.
- Mean hospitalization duration was 31.9 days, with significant functional decline observed (p < 0.001).
- Laboratory tests revealed dehydration and muscle injury, with median creatine kinase levels at 1638 IU/L.
Study Design
Type
Observational (n=40)
Structured PICO
What are the clinical features and outcomes of acute sustained immobilization in Parkinson's disease requiring emergency hospitalization?
P
Population
40 Parkinson's disease patients who developed acute immobilization lasting ≥12 h and required emergency transportation and hospitalization (mean age 76.5 ± 8.6 years; 42.5% female).
O
Outcome
Clinical characteristics, precipitating factors, laboratory findings, and outcomes of acute sustained immobilization
Acute sustained immobilization in Parkinson's disease without classical malignant features is associated with prolonged hospitalization and significant functional decline.
Main Result
Absolute Event Rate: 3.2% vs 2.5%
p-value: p=<0.001
Abstract
AbstractBackground Acute deterioration in Parkinson's disease (PD) often results in emergency hospitalization. While parkinsonism–hyperpyrexia syndrome (PHS) represents the most severe malignant form, acute motor worsening without hyperthermia is frequently encountered. Objective To characterize the clinical features and outcomes of acute sustained immobilization in PD requiring emergency hospitalization. Methods We conducted a retrospective observational study of PD patients who developed acute immobilization lasting ≥12 h and required emergency transportation and hospitalization. Clinical characteristics, precipitating factors, laboratory findings, and outcomes were analyzed. Results Forty patients were included (mean age 76.5 ± 8.6 years; 42.5% female). Most patients were alert at admission (median Glasgow Coma Scale 15 IQR 14–15) and lacked hyperthermia or overt autonomic instability. Falls were the most frequent precipitating event (45%). The mean duration of immobilization before hospital arrival was 24 h (IQR 16–38). Laboratory findings indicated dehydration and muscle injury (median creatine kinase 1638 IU/L, IQR 431–4543). Mean hospital stay was 31.9 ± 22.1 days. Functional status worsened significantly, with modified Rankin Scale scores increasing from 2.5 ± 0.8 to 3.2 ± 1.0 (p Conclusions Acute sustained immobilization without classical malignant features such as hyperpyrexia or autonomic instability represents a clinically significant pattern of acute motor deterioration in PD, associated with prolonged hospitalization and functional decline. We propose the term acute akinetic collapse (AAC) to describe this underrecognized clinical presentation. Recognition of AAC may facilitate earlier intervention and preventive strategies.