Introduction: Patients with Parkinson’s disease have episodes of worsening of motor and nonmotor symptoms. Such exacerbations can be mistaken as intrinsic worsening of the disease per se, leading to unnecessary dose adjustments. Whereas in reality, these are due to secondary causes. In spite of the clinical significance and social impact of motor exacerbations, there is little research work available from the literature. Aim: To study on the causes, consequences and predictors of motor exacerbations in Idiopathic Parkinson’s disease. Materials and Methods: Place of study; Institute of Neurology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai. Study design and duration; Between August 2012 and December 2014, prospective observational study. Results: The study group consisted of 87 subjects which includes 28 females. The Exacerbations group had a later age of onset and longer duration. The mean UPDRS ADL for exacerbations group is 27.2 whereas the mean for control group is 22.6. The basic MMSE had a significant p value. Various causes for motor exacerbations were: medication errors, medical illness, psychiatric problems, alcohol, smoking, and surgical procedure. The commonest cause in our study was medication errors followed by medical illnesses. Two patients had worsening of motor features following episode of binge drinking. One patient had worsening of motor features due to surgical problem. Two patients had worsening who were having depression and anxiety. A combination of these occurred in majority of the cases. Patients presenting with worsening of tremor had better prognosis and they recovered almost fully. Conclusion: This study reveals that Medication errors, Systemic medical problems, Psychological causes, Alcohol and surgical problems can worsen the motor exacerbations. Medication errors followed by diverse medical conditions are the common causes. Motor exacerbations due to various causes is reversible in most of the cases.

Keywords: Parkinson’s Disease; Motor Exacerbation; Medication Errors.