A BSTRACT Fever is a common symptom encountered in clinical practice. Hyperthermia, though infrequently encountered, can be genetical (malignant hyperthermia) or acquired when the body temperature rises beyond a certain set point that is controlled by the hypothalamus. We report a case of an elderly male who reported to us with hyperthermia, accelerated hypertension, and brain haemorrhage (as a sequelae of uncontrolled hypertension). A thorough clinical history pointed towards neuroleptic malignant syndrome (NMS). A remarkable response was observed with dantrolene and bromocriptine along with the discontinuation of the offending drug. With conservative management, the patient had complete recovery. This case highlights the importance of even sub-therapeutic drug dosage, particularly neuropsychiatric drugs, in the development of neurological catastrophe.
A BSTRACT Lateral medullary syndrome (LMS) or Wallenberg’s syndrome is an uncommon and often underdiagnosed cause of posterior circulation stroke. Thrombosis, embolization, or dissection of vertebral or posterior inferior cerebellar artery (PICA) often results into LMS. The most pathognomonic symptoms of LMS includes pain and temperature deficits on ipsilateral facial side and contralateral side of rest of the body, ipsilateral ataxia, vertigo, nystagmus, dysphagia, hoarseness, hiccups and Horner’s syndrome. We report a case of LMS in a 49-year-old Indian female with no known classical risk factors for stroke who presented with chief complaints of debilitating headache. Clinical examination was suggestive of LMS and radiological investigation confirmed the diagnosis. Patient’s hospital stay was uneventful and she was discharged to home with gradual improvement in her symptoms.
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