Neuroleptic Malignant Syndrome

A Case of Neuroleptic Malignant Syndrome

The author reported a case of neuroleptic malignant syndrome (NMS). The patient was 26 year old male who was admitted under the impression of schizophrenia, paranoid type. His chief complaints were persecutory delusion, auditory hallucination, insomnia and agitation. The patient received chlorpromazine initially and haloperidol was added later. On the 37th hospital day, mutism, immobility, muscle rigidity,stuporous mental state, sialorrhea, tachycardia, hypertension and hyperthermia were noted. CBC, RUA, VDRL, CSF study, CT, EKG and EEG showed no pathology except sinus tachycardia during the above mentioned condition. Neuroleptic medication was withdrawn immediately under the impression of possible NMS. The patient was treated with Benztropine mesylate and other supportive therapy. Hyperthermia diasppeared on the following day, but tachycardia, hyper tension, muscle rigidity, sialorrhea remained still. On the 10th day after the development of the NMS, vital signs were nearly within normal limits but muscle rigidity and sialorrhea were persistant. No further evaluation was possible because of abrupt discharge against medical advice. The author suggested that the patient had NMS induced by neuroleptics and was manageable by early diagnosis and proper treatment.