Neuroleptic malignant syndrome

South Med J. 1986 Mar;79(3):331-6. doi: 10.1097/00007611-198603000-00018.

Abstract

The neuroleptic malignant syndrome (NMS) is a rare but potentially lethal disorder associated with the administration of neuroleptic agents. This syndrome may be underdiagnosed because it is poorly understood and often unrecognized. It affects all age groups and has a 20% mortality. Presenting features include extrapyramidal symptoms, altered mental consciousness, autonomic dysfunction, and hyperthermia. The underlying explanation for these manifestations is a disturbance of the dopaminergic system within the basal ganglia and hypothalamus. Dantrolene (Dantrium), amantadine (Symmetrel), and bromocriptine mesylate (Parlodel) have been efficacious in conjunction with supportive therapy. I report three cases successfully treated with bromocriptine and supportive therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Benztropine / adverse effects
  • Benztropine / analogs & derivatives
  • Bromocriptine / therapeutic use
  • Catatonia / diagnosis
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Fluphenazine / adverse effects
  • Fluphenazine / analogs & derivatives
  • Haloperidol / adverse effects
  • Heat Exhaustion / diagnosis
  • Humans
  • Male
  • Malignant Hyperthermia / diagnosis
  • Middle Aged
  • Neuroleptic Malignant Syndrome / diagnosis*
  • Neuroleptic Malignant Syndrome / drug therapy
  • Psychotic Disorders / drug therapy
  • Schizophrenia, Paranoid / drug therapy
  • Time Factors

Substances

  • Benztropine
  • Bromocriptine
  • Haloperidol
  • fluphenazine enanthate
  • Fluphenazine