Abstract
Impaired thermoregulation and heat intolerance may be intrinsic to autonomic dysfunction in Parkinson’s disease due to disturbances in perspiration regulation. Thermoregulatory impairment leading to hyperthermia/heatstroke can be accentuated with the usage of anticholinergics, which block the ability to sweat. Oxybutynin chloride is one of the most used anticholinergic agents in clinical practice for the management of detrusor hyperreflexia secondary to neurogenic bladder dysfunction and is often used in the setting of Parkinson’s disease. We present a rare instance of oxybutynin-induced heatstroke in an elderly patient with Parkinson’s disease.
Highlights
The presence of a wide array of non-motor symptoms indicates that Parkinson’s disease is not restricted to the substantia nigra or central dopaminergic system [1]
Heatstroke is a common cause of hyperthermia and approximately 80% of deaths associated with heatstroke occur in individuals older than 50-years-old [10]
It is important to note that most patients recover fully after a short period of hyperthermia, but patients exposed to higher temperatures for extended periods of time are more susceptible to progression to multiorgan failure and possible death
Summary
The presence of a wide array of non-motor symptoms indicates that Parkinson’s disease is not restricted to the substantia nigra or central dopaminergic system [1]. Over one-third of Parkinson’s disease patients can be assumed to have a thermoregulatory dysfunction with perspiration-related symptoms. Individuals with impaired thermoregulatory sweating due to neurological disease states may be at greater risk of symptomatic anhidrosis from taking drugs with anticholinergic activity; this includes medications such as oxybutynin [8]. The patient was warm and non-responsive to her family; the patient’s daughter took her oral temperature which read 107 °F, at which point the family contacted emergency medical services (EMS). The patient started taking oxybutynin extended-release 5 mg oral, once daily, roughly five days prior to presentation to. There were no reported alleviating or exacerbating factors to the patient’s condition The patient remained in the MICU without demonstrating leukocytosis or growth in blood, urine, sputum, and cerebrospinal fluid cultures. The patient was instructed to refrain from taking oxybutynin and to follow up with urology for possible alternative management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
