Neuroleptic Malignant Syndrome
From Anvita Health Wiki
Contents |
Etiology
-
- high potency neuroleptics
- haloperidol*
- fluphenazine*
- trifluoperazine
- bromperidol
- domperidone
- thiothixene
- molindone
- less potent neuroleptics
- other antipsychotics
- other agents
- * most common offending agents
Pathology
- inhibition of dopamine receptors in the hypothalamus
- increased heat generation
- decreased heat dissipation
Clinical-manifestations
- hyperthermia
- muscle rigidity
- autonomic instability
- tachycardia
- tachypnea
- diaphoresis
- blood pressure alterations
- altered mental status
- seizures
- arrhythmias
- rhabdomyolysis
- syndrome occurs within 2 weeks of initiation of
Laboratory
- complete blood count ( CBC) leukocytosis
- serum creatine kinase: marked increase
- urine myoglobin: increased
Diagnostic-procedures
Differential-diagnosis
Management
- discontinue use of antipsychotic agent ( neuroleptic)
- supportive measures
- ventilation
- cooling
- hydration
- dantrolene (direct muscle relaxant)
- bromocryptine 5-15 mg TID or Sinemet 25/100 QID
More General Terms
Additional Terms
- altered mental status (AMS)
- antipsychotic agent
- bromocriptine (Parlodel, Cycloset)
- carbidopa/levodopa (Sinemet, Parcopa, Atamet)
- catatonia
- dantrolene (Dantrium)
- electroconvulsive therapy (ECT)
- hyperthermia (pyrexia)
- muscle rigidity
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1146
- Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 88
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 712
- Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
- NINDS Neuroleptic Malignant Syndrome Information Page [1]
