Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality

Modi, Sumul; Dharaiya, Devanshi; Schultz, Lonni; Varelas, Panayiotis N.

doi:10.1007/s12028-015-0162-5

Cited by 85 publications

(78 citation statements)

References 17 publications

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“…In a study on 1,346 NMS patients, rhabdomyolysis was reported as the most prevalent complication (30.1%) compared to other associated complications 90. Electrolyte imbalances can cause serious cardiac arrhythmias that may end up in cardiac arrest if not treated promptly.…”

Section: How To Approach a Suspected Case Of Nmsmentioning

confidence: 99%

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Oruch¹,

Pryme²,

Engelsen³

et al. 2017

NDT

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Neuroleptic malignant syndrome is an unpredictable iatrogenic neurologic emergency condition, mainly arising as an idiosyncratic reaction to antipsychotic agent use. It is characterized by distinctive clinical features including a change in mental status, generalized rigidity, hyperpyrexia, and dysautonomia. It can be lethal if not diagnosed and treated properly. Mortality and morbidity attributed to this syndrome have recently declined markedly due to greater awareness, earlier diagnosis, and intensive care intervention. In most cases, the syndrome occurs as a result of a rapid increase in a dose of neuroleptic, especially one of the long-acting ones. Pathophysiology behind this syndrome is attributed to a dopamine receptor blockade inside the neurons rendered by the offending drug and excessive calcium release from the sarcoplasmic reticulum of skeletal myocytes. Laboratory tests, although not diagnostic, may assist in assessing the severity of the syndrome and also the consequent complications. The syndrome has been described in all age groups and occurs more in males than in females. Genetics appears to be central regarding the etiology of the syndrome. Stopping the use of the offending agent, cold intravenous fluids, and removal of the causative agent and its possible active metabolites is the cornerstone of treatment. Periodic observation of psychotic patients recently started on antipsychotic medications, especially those being treated with depot preparations, may aid to an early diagnosis of the syndrome and lead to early treatment.

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Section: How To Approach a Suspected Case Of Nmsmentioning

confidence: 99%

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Oruch¹,

Pryme²,

Engelsen³

et al. 2017

NDT

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“…Neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction that can sometimes be life threatening can occur with metoclopramide and other DRBAs . The clinical triad consists of hyperthermia, rigidity, and alteration of mental status.…”

Section: Expert Opinionmentioning

confidence: 99%

Movement Disorders From the Use of Metoclopramide and Other Antiemetics in the Treatment of Migraine

2015

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Nausea and vomiting are a frequent accompaniment of migraine and anti-nausea medications are frequently used in its management. The majority of anti-nausea medications that are used in migraine are dopamine receptor blocking agents and therefore have the potential to cause drug-induced movement disorders. This article explores the risk of such drug-induced movement disorders in migraineurs who were treated with these medications.

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“…Our patient had improvement of fever and rigidity with dantrolene, but cardiorespiratory status continued to decline until he expired. Acute respiratory failure is the strongest independent predictor of mortality [13]. Other prognostic factors include acute renal failure, coexisting heart failure, and infections [5].…”

Section: Discussionmentioning

confidence: 99%

Acute Abdomen with Ileus: A Heralding Presentation of Neuroleptic Malignant Syndrome

Chime

Al-Emam

Kumar

et al. 2018

Case Rep Gastroenterol

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The pathophysiology of neuroleptic malignant syndrome (NMS) with use of psychotropic drugs is still unclear. Although a rare event with an incidence of 0.02–3.2%, when not promptly recognized and managed, it carries a high mortality (10–20%) and morbidity rate. Presentation can be either typical, with muscle rigidity and hyperpyrexia, or atypical, the latter posing diagnostic and early management challenges in clinical practice. Our patient presented with delayed fever and ileus, making early diagnosis difficult. We propose that NMS be considered an alternate diagnosis in patients using psychotropic medications and manifest ileus and delayed fever, especially after other differentials have been excluded.

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Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality

Cited by 85 publications

References 17 publications

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Movement Disorders From the Use of Metoclopramide and Other Antiemetics in the Treatment of Migraine

Acute Abdomen with Ileus: A Heralding Presentation of Neuroleptic Malignant Syndrome

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