The akinetic crisis is defined as an acute, potentially life-threatening, levodopa-resistant, severe aggravation of rigidity, severe akinesia, associated with high fever, disturbance of consciousness, dysphagia and autonomic symptoms often due to disruption of dopaminergic medication or infections. The akinetic crisis is a relatively rare event, however subacute mild-moderate motor symptom deterioration in Parkinson´s disease (PD) patients is a frequent cause of hospitalization. In this review, we propose that the akinetic crisis is the upper end of a continuous spectrum of acute akinetic states depending on the degree of the progressive levodopa-resistance. Clinical symptomatology, risk factors, and instrumental diagnostics as the DAT-SPECT reflecting a biomarker of levodopa-resistance will be discussed to evaluate the spectrum of akinetic states. Pathophysiological considerations about the potential role of proinflammatory cytokines on the progressive levodopa-resistance will be discussed and therapeutical, consensus-based guidelines will be presented.

运动危象被定义为急性，可能危及生命，左旋多巴耐药，严重加重僵硬，严重运动不能，与高烧有关，意识障碍，吞咽困难和自主神经症状，通常是由于多巴胺能药物或感染的破坏。运动危象是一种相对罕见的事件，但帕金森病 （PD） 患者的亚急性轻中度运动症状恶化是住院的常见原因。在这篇综述中，我们提出运动障碍危象是急性运动障碍态连续谱的上限，具体取决于进行性左旋多巴抵抗的程度。将讨论反映左旋多巴耐药生物标志物的 DAT-SPECT 的临床症状、危险因素和仪器诊断，以评估运动障碍状态的范围。将讨论有关促炎细胞因子对进行性左旋多巴耐药的潜在作用的病理生理学考虑，并提出基于共识的治疗指南。