A RARE AND A FATAL CAUSE OF HYPERTHERMIA, A CASE REPORT OF NEUROLEPTIC MALIGNANT SYNDROME
Abstract
Abstract : A young female presented with the complaints of 4 episodes of generalized tonic -clonic seizures. Past history revealed that she had viral meningoencephalitis 6 months back, after which she developed psychosis and was on antipsychotics since then. Seizures got controlled with antiepileptics. Patient developed aggressive behaviour and antipsychotics doses were escalated gradually. Patient developed catatonia and tremors. Patient was treated with benzodiazepines for rigidity and she developed fever after 4 days of hospitalization. Fever didnt subside with medications, fever workup turned out to be negative for infective cause. CT brain was normal. MRI BRAIN was normal. Patient had tachycardia, diaphoresis, leucocytosis and elevated CPK levels and she was diagnosed to have Neuroleptic malignant syndrome. Patient was managed with dopamine agonists and supportive measures. despite treatment, she went in for arrhythmia and sudden cardiac arrest. Patient died .This case was presented for a rare and a fatal cause of hyperthermia.
Keyword :ANTIPSYCHOTICS, FEVER, NEUROLEPTIC MALIGNANT SYNDROME
Full Text:
PDFReferences
Delay J, Pichot P, Lempiere T, Blissade B, Peigne F. Unneurolptique.majeur non phenothiazinique et non reserpinique, I’haloperidol, dans le traitement des psychoses. Ann Med P sychol 1960: 18: 145- 152.
Levenson JL.Neuroleptic malignant syndrome.Am J Psychiatry 1985; 142:1137.
Velamoor VR. neuroleptic malignant syndrome, Recognition,Prevention and management Drug Saf 1998;19:73.
Adnet P, Lestavel P, Krivosic-Horber R. Neuroleptic malignant syndrome. Br J Anaesth. 2000; 85(5):129-135.
Strawn JR, Keck PE, Caroff SN. Neuroleptic malignant syndrome Am J Psychiatry. 2007; 164 (5):870-876.
Neuroleptic Malignant Syndrome. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994:739-742.
An international consensus study of neuroleptic malignant syndrome diagnostic criteria using the Delphi method.Gurrera RJ, Caroff SN, Cohen A, Caroll BT, DeRoos F, Francis A ,Frucht S, Gupta S, Levenson JL, Mahmood A ,Mann SC, Policastro MA, Rosebush PI, Rosenberg H, Sachdev PV, Trollor JN,Velamoor VR, Watson CB, Wilkinson JR.Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA. J.clinical Psychiatry. 2011 Sep; 72(9):1222-8.
Neuroleptic Malignant Syndrome: A Review for Neurohospitalists. Brian D. Berman the Neurohospitalist 2011 1: 41. DOI: 10.1177/1941875210386491.
Shalev A Hermesh H. Munitz H. Mortality from neuroleptic malignant syndrome . J Clin Psychiatry 1989:50:18. 10.Lejoyeux M.Fineyre F.Ades J.The serotonin syndrome.Am J Psychiatry 1992; 149:1410. 11.Stembach H. The serotonin syndrome .Am J. Psychiatry 1991; 148:705.
Rosenberg MR, Green M. Neuroleptic malignant syndrome -review of responseto therapy. Arch Internal Med. 1989; 149(9):1927-1931.
Bond WS. Detection and management of the neuroleptic malignant syndrome. Clin Pharm 1984;3: 302.
Trollor JN, Sachdev PS Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Aust N-Z J Psychiatry 1999; 33: 650. 15.Sakkas P, Davis JM, Janicak PG, Wang ZY. Drug-treatment of the neuroleptic malignant syndrome. Psychopharmacol Bull. 1991; 27(3):381-384.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
An initiative of The Tamil Nadu Dr M.G.R. Medical University