Abstract
Neuroleptic malignant syndrome (NMS) is a rare neurological emergency with mortality being as high as 38 % in the past. Early diagnosis and improved management have decreased mortality to less than 10 % at present. The causes include typical neuroleptic medications which are potent dopamine antagonists (e.g., chlorpromazine and haloperidol). NMS has also been associated with metoclopramide, carbamazepine, and lithium use as well as levodopa withdrawal. Timely assessment and treatment is very important. Clinical features include fever, hypertension and autonomic instability, change in mental status, diffuse muscular rigidity, and rhabdomyolysis. Typical laboratory findings include an elevated white cell count and CK. Patient may have myoglobinuria and abnormal liver function tests. Management includes cessation of the offending agent, I.V. fluid therapy, and antipyresis. Specific agents employed include dantrolene and bromocriptine (or amantadine).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ahuja N, Cole AJ. Hyperthermia syndromes in psychiatry. Adv Psychiatr Treat. 2009;15(3):181–91.
Akpaffiong MJ, Ruiz P. Neuroleptic malignant syndrome: a complication of neuroleptics and cocaine abuse. Psychiatr Q. 1991;62(4):299–309.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Rana, A.Q., Morren, J.A. (2013). Neuroleptic Malignant Syndrome (NMS). In: Neurological Emergencies in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-5191-3_13
Download citation
DOI: https://doi.org/10.1007/978-1-4471-5191-3_13
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-5190-6
Online ISBN: 978-1-4471-5191-3
eBook Packages: MedicineMedicine (R0)