A can ’t miss item in the differential diagnosis of neuroleptic malignant syndrome

2 out of 5 stars Psychiatric Emergencies for Clinicians: Emergency Department Management of Neuroleptic Malignant Syndrome. Wilson MP et al. J Emerg Med 2016;51:66-69. Reference This review article about neuroleptic malignant syndrome (NMS) is brief but disappointing and misleading on some points. For example, the authors state that: The majority of cases of NMS develop symptoms within the first week [after starting the offending medication], and virtually all develop symptoms within the first 30 days. The clinician who takes this statement to the bank could easily miss late-onset NMS occurring as a result of dose change, additional medication, or concurrent illness and dehydration. The clinical scenario the authors present to start the discussion doesn’t even mention the patient’s medications. On the controversial topic of the role of dantrolene in treating NMS, the paper’s conclusion: . . .the evidence on the use of dantrolene is contradictory, and all recommend its use. is gibberish, since “all” doesn’t have a recognizable antecedent The bottom line is that the evidence is indeed contradictory, but many authors recommend use of dantrolene in severe cases since there doesn’t seem to be much downside. One would hope that a just-published review article would be up-to-date and include important recent information, but the authors do miss a key point. Table 3 lists a differential diagnosis for NMS, but there’s a crucial omissi...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical anti-NMDA receptor encephalitis dantrolene neuroleptic malignant syndrome Source Type: news