Diagnostic and therapeutic challenges in neuroleptic malignant syndrome: a severe medical case.

Diagnostic and therapeutic challenges in neuroleptic malignant syndrome: a severe medical case. Riv Psichiatr. 2020 Jul-Aug;55(4):236-239 Authors: Brogna P, Colasuonno R, Di Michele F, Paterniti AM, Talamo A, Ribolsi M, Jannini TB, Siracusano A, Niolu C Abstract Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic medical emergency usually associated with the use of dopamine antagonists, commonly typical antipsychotic drugs. However, it has been observed that it can occur with atypical antipsychotics as well. NMS is characterized by altered consciousness, fever, rigidity, autonomic instability and high creatine phosphokinase (CPK) blood levels. Here, we report a case of a 44-year-old female patient with history of a treatment-resistant bipolar disorder. She was admitted to our psychiatric ward for severe psychomotor agitation and treated with a therapy based on typical and atypical antipsychotics. During the course of the hospitalization she developed NMS. In this case, the diagnosis was delayed due to the slow and insidious symptom presentation, therefore requiring a differential diagnosis. Autoimmune NMDA receptor encephalitis, catatonic syndrome and malignant catatonia have been excluded. The patient met all the DSM-5 criteria for NMS: exposure to dopamine-blocking agent, severe muscle rigidity, fever, diaphoresis, dysphagia, altered level of consciousness, mutism, tremors, tachycardia, high or labile blood pressure, leuk...
Source: Rivista di Psichiatria - Category: Psychiatry Tags: Riv Psichiatr Source Type: research