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HardParkinson's Disease & Movement DisordersMissed Parkinson's Medication - Acute Deteriorationuk-dgm
A 80-year-old woman has been admitted from a care home with a 5-day history of progressive drowsiness and reduced oral intake. She has advanced Parkinson's disease, is normally able to communicate but is now minimally responsive. Her medications include Co-careldopa 25/250 mg QDS, Entacapone 200 mg QDS, Quetiapine 25 mg at night, and Paracetamol 1 g QDS. Her observations are: T 36.8°C, HR 88, BP 100/62 lying (unable to stand), SpO2 96% on air, RR 16. 4AT score is 8. All blood tests are unremarkable. What is the MOST likely cause of her presentation?