Alcohol Withdrawal Mimicking Neuroleptic Malignant Syndrome

Abstract

Long-standing, heavy alcohol use can lead to alcohol dependence, which predisposes to alcohol withdrawal if alcohol consumption is suddenly decreased or stopped. Alcohol withdrawal syndrome is characterized by a hyperadrenergic response, with symptoms ranging from mild tremulousness to delirium tremens. We report a 55-year-old male presenting with hyperthermia, tachycardia, tachypnea, altered consciousness, tremors, rigidity, diaphoresis, elevated creatinine kinase, and myoglobinuria. The diagnosis of alcohol withdrawal was made due to a history of alcohol use disorder with the last drink two days ago and no history of any medication or drug intake prior to admission. He was treated with benzodiazepines with an improvement in his condition.

Management of a trauma patient with alcohol withdrawal who developed neuroleptic malignant syndrome in Korea: a case report

“…Alcohol withdrawal mimics NMS with characteristic hyperadrenergic responses, altered mentality, rigidity, and elevated CK [7]. However, the mechanism is distinct from that of NMS.…”

Severe diaphoresis and fever during alcohol withdrawal cause hypovolemic shock: case report

“…The need for adequate hydration during alcohol withdrawal has been stated [3,5], although this was not mentioned in the context of diaphoresis but of general care for patients with alcohol use disorder. In the clinical practice of psychiatry, however, the close relationship between diaphoresis and hypovolemia has been described in the context of neuroleptic malignant syndrome or malignant catatonia [8,16], for which the symptoms resemble alcohol withdrawal syndrome [17]. Both conditions feature increased adrenergic activity and exhibit its related medical conditions, e.g., diaphoresis, fever, hyperthermia, and arrhythmia [3,18].…”