Case study: neuroleptic malignant syndrome without pyrexia. 1996

A F Hynes, and E L Vickar
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.

Fever is generally considered to be an essential feature of neuroleptic malignant syndrome (NMS). The authors present the case of a 12-year-old boy who had many features of NMS but did not have fever. This case emphasizes the importance of assessing the total clinical situation. It also supports the concept of neuroleptic-induced catatonia (NIC) and NMS as disorders on the same spectrum. A scoring system is offered as a guide to severity of NIC-NMS.

UI MeSH Term Description Entries
D008297 Male Males
D009459 Neuroleptic Malignant Syndrome A potentially fatal syndrome associated primarily with the use of neuroleptic agents (see ANTIPSYCHOTIC AGENTS) which are in turn associated with dopaminergic receptor blockade (see RECEPTORS, DOPAMINE) in the BASAL GANGLIA and HYPOTHALAMUS, and sympathetic dysregulation. Clinical features include diffuse MUSCLE RIGIDITY; TREMOR; high FEVER; diaphoresis; labile blood pressure; cognitive dysfunction; and autonomic disturbances. Serum CPK level elevation and a leukocytosis may also be present. (From Adams et al., Principles of Neurology, 6th ed, p1199; Psychiatr Serv 1998 Sep;49(9):1163-72) Neuroleptic-Induced Neuroleptic Malignant Syndrome,Neuroleptic-Malignant Syndrome, Neuroleptic Induced,NMS (Neuroleptic Malignant Syndrome),NMSs (Neuroleptic Malignant Syndrome),Neuroleptic Induced Neuroleptic Malignant Syndrome,Neuroleptic Malignant Syndrome, Neuroleptic Induced,Neuroleptic Malignant Syndromes,Syndrome, Neuroleptic Malignant,Syndromes, Neuroleptic Malignant
D009460 Neurologic Examination Assessment of sensory and motor responses and reflexes that is used to determine impairment of the nervous system. Examination, Neurologic,Neurological Examination,Examination, Neurological,Examinations, Neurologic,Examinations, Neurological,Neurologic Examinations,Neurological Examinations
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005334 Fever An abnormal elevation of body temperature, usually as a result of a pathologic process. Pyrexia,Fevers,Pyrexias
D006220 Haloperidol A phenyl-piperidinyl-butyrophenone that is used primarily to treat SCHIZOPHRENIA and other PSYCHOSES. It is also used in schizoaffective disorder, DELUSIONAL DISORDERS, ballism, and TOURETTE SYNDROME (a drug of choice) and occasionally as adjunctive therapy in INTELLECTUAL DISABILITY and the chorea of HUNTINGTON DISEASE. It is a potent antiemetic and is used in the treatment of intractable HICCUPS. (From AMA Drug Evaluations Annual, 1994, p279) Haldol
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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