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- Neuroleptic Malignant Syndrome (NMS) is a life-threatening complication of anti-psychotic medication therapy.
- While NMS is rare (0.02 to 2.44% amongst those taking neuroleptic drugs), its associated mortality (up to 12%) and morbidity (i.e. rhabdomyolysis, pneumonia, seizures, renal failure, disseminated intravascular coagulation (DIC), respiratory failure) are severe.
- Historically, there has been little consensus about universally accepted diagnostic criteria for NMS, until an expert panel of various physician specialists recently convened and determined the following criteria:
- Exposure to dopamine agonist or dopamine agonist withdrawal within past 72 hours
- Hyperthermia
- Rigidity
- Mental status alteration
- Elevated creatinine phosphokinase
- Sympathetic nervous system lability (2 or more of the following: elevated blood pressure, fluctant blood pressure, urinary incontinence, diaphoresis)
- Tachycardia and tachypnea
- Negative work-up for infectious, metabolic, neurologic, or toxic etiologies.
- Treatment includes immediate withdrawal of any antipsychotic medication and is, otherwise, largely supportive.
References
- The Neuroleptic Malignant Syndrome Information Service. International Expert Panel Consensus on Diagnostic Criteria for NMS.