Background:
Thermoregulatory dysfunction is a known, but perhaps underreported, phenomenon in Parkinson’s disease (PD) and related disorders. Multiple anatomical structures have been implicated. Most often hyperpyrexia is observed. Severe hypothermia is a rarer, but documented, phenomenon. We present a case of severe acute hypothermia in a patient with Dementia with Lewy Bodies (DLB) and compare this to multiple cases of severe hypothermia in PD.
Design/Methods:
Case: An 82-year-old male diagnosed with DLB based upon the presence of dementia and hallucinations five years prior to onset of levodopa-responsive parkinsonism. An episode of orthostatic hypotension led to a presentation to our hospital where rectal temperature was recorded 94.4 °F (34.6 °C). He normalized after passive re-warming. The patient presented a second time 4 days later with similar symptoms and rectal temperature was recorded 92.0 °F (33.3 °C). He was successfully re-warmed but ultimately discharged to hospice. No clear precipitating factors were identified, and these episodes had occurred in the late spring in the US Pacific Northwest. We then compared our case to 10 other cases of hypothermia found upon literature review, all occurring in patients with PD, to identify any common characteristics. In all cases bradycardia and altered mental status was present, with some degree of worsened rigidity in each case. Medication burden varied in each case.
Conclusions:
Thermoregulatory dysfunction can be a consequential symptom of Lewy Body diseases. Population prevalence studies are needed to elucidate the extent of this dysfunction. Better understanding of the involved structures may aid in the understanding of the progression of Lewy Body diseases, perhaps contribute to earlier diagnosis of these conditions and prediction of phenotype, and to develop more specific treatment for severe dysfunction.
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