Neuroleptic Malignant Syndrome

  • Stanley N. Caroff
  • Stephan C. Mann
  • E. Cabrina Campbell
  • Kenneth A. Sullivan
  • Jose Obeso
Part of the Current Clinical Neurology book series (CCNEU)


Patient 1: A-16-year-old woman, who lives on a farm and spends time outdoors had been well with no psychiatric history until 1 week prior to admission. At that time, she developed difficulty sleeping and bizarre behavior including assault, sobbing, undressing in public, and thoughts of suicide that prompted admission to the hospital. On examination, she is labile, agitated, and delusional and experiences tactile, visual, and auditory hallucinations. She is found to have impaired recall, dyscalculia, and right-sided sensory deficits. She is started on 2 mg of haloperidol orally twice a day, and she also receives 5 mg intramuscularly for worsening agitation. Within a few hours, she develops a temperature of 39.8°, tachycardia, diaphoresis, and board-like rigidity with cogwheeling, tremors, and mutism. A generalized seizure is observed. Despite administration of diphenylhydantoin, steroids, diazepam, benztropine, and three electroconvulsive treatments, she remains rigid and unresponsive with temperatures up to 40.5°.


Dopamine Agonist Neuroleptic Malignant Syndrome Malignant Hyperthermia Malignant Hyperthermia Delirious Mania 
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Copyright information

© Humana Press Inc. 2005

Authors and Affiliations

  • Stanley N. Caroff
    • 1
  • Stephan C. Mann
    • 1
  • E. Cabrina Campbell
    • 1
  • Kenneth A. Sullivan
    • 1
  • Jose Obeso
    • 2
  1. 1.Department of PsychiatryUniversity of Pennsylvania School of Medicine and the Department of Veterans Affairs Medical CenterPhiladelphia
  2. 2.Department of Neurology, Clinica Universitaria and Medical SchoolUniversity of NavarraPamplonaSpain

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