A Neuroleptic Malignant Syndrome Without Rigidity

Özdemir, İlker; Kuru, Erkan; Şafak, Yasir; Tulacı, Rıza Gökçer

doi:10.30773/pi.2017.06.05

Cited by 12 publications

(13 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the clinical presentation of NMS can be heterogeneous and challenging (Table 5) [13,[20][21][22][23]. Cases of NMS without muscle rigidity have been reported in the literature [24,25] as well as in this study (10% of the sample). Other extrapyramidal motor symptoms, such as tremor, chorea, akinesia, mutism, dysarthria, dysphagia, and other dystonic movements, may guide the diagnosis, but they are inconstant and non-specific.…”

Section: Discussionmentioning

confidence: 70%

Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review

et al. 2021

View full text Add to dashboard Cite

Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.

show abstract

Section: Discussionmentioning

confidence: 70%

Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Nevertheless, our patient had neither hyperthermia nor muscle rigidity, which are necessary criteria for such a diagnosis to be made. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

Major depressive disorder (MDD), antidepressants, and uncontrolled hypertension

Theodosopoulou

Paraskeva

2022

Saudi Journal of Anaesthesia

View full text Add to dashboard Cite

Objective: Major depressive disorder (MDD) represents the leading cause of mental disability worldwide. While relations between MDD and alterations to the cardiovascular system have been studied before, the autonomic dysfunction caused by the disease and the medical therapies involved during treatment has not been widely reported. Our case aims to prove such linkage exists and is a potent hazard during major operative procedures. Methods: Studies have associated the disorder with a concomitant dysfunction of the autonomic nervous system, predisposing patients to hypertension. We present the case of a patient presenting with an intraoperative hypertensive spike that could be attributed to such a dysregulation of the autonomic system, in the absence of any other possible explanation. Results: The observed intraoperative hypertensive spike was managed pharmacologically, and the patient did not experience any further hemodynamic instability or postoperative complications. Conclusion: Our case tries to highlight a disregarded aspect of perioperative management for patients suffering from MDD.

show abstract

“…Most of the NMS cases in literature are associated with administration of dopamine receptor antagonist or sudden alteration in their dosage. [ 6 ] A lesser discussed yet equally significant entity and unusual cause of NMS other than dopamine antagonism is the disrupted striatal dopaminergic drive because of dopamine agonist.To the best of our knowledge, this is the first presentation of a case series of five patients with pharmacological- or medical-related hypo-dopaminergic crisis leading to features of NMS along with the first case report of NMS in PD after sudden discontinuation of levosulpiride (Case3). Although, NMS with olanzapine is well documented, no prior case of NMS with hypothyroidism (Case4) on olanzapine exists in literature.…”

Section: Discussionmentioning

confidence: 99%

Widening spectrum of neuroleptic malignant syndrome: Case series

Paul¹,

Paul²,

Singh³

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

View full text Add to dashboard Cite

Neuroleptic malignant syndrome (NMS) is a rare and rapidly progressive syndrome with mortality rate of 5.6%. The spectrum of onset, progression and outcome is heterogeneous and is associated with number of risk factors. In our case series, we entail the triggers, hospital course and outcome of five interesting in-patient cases that were admitted to our service in a tertiary care hospital in Northern India. This case series is to highlight the first ever reported case of NMS triggered by levosulpiride administration, along with one of the few first cases of NMS after programming of DBS, hypothyroid disorders, levodopa readjustment and selective basal ganglia and cerebellar injury following the hyperthermic syndrome. This is also to bring to attention of clinicians worldwide the atypical risk factors of NMS, and stress the importance of staying vigilant for the same by frequent follow-ups and high degree of clinical suspicion. We also aim to generate epidemiological data about these atypical triggers.

show abstract

A Neuroleptic Malignant Syndrome Without Rigidity

Cited by 12 publications

References 12 publications

Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review

Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review

Major depressive disorder (MDD), antidepressants, and uncontrolled hypertension

Widening spectrum of neuroleptic malignant syndrome: Case series

Contact Info

Product

Resources

About