Neuroleptic Malignant Syndrome

Neuroleptic Malignant Syndrome (NMS) • S/S include fever, rhabdomyolysis, tachycardia, hypertension, agitation, muscle rigidity, and acidosis, mental changes, and stupor, hypoxia, acidosis, ↑CK, and myoglobinuria • The mortality rate is unknown, but may be as high as 20%. Dantrolene is an effective therapeutic modality in many cases of NMS. • there are significant differences between the two. MH is acute, whereas NMS often occurs after longer term drug exposure. • Phenothiazines and haloperidol or any of the newer potent antipsychotic agents alone or in combination are usually triggering agents for NMS • Sudden withdrawal of drugs used for Parkinson's disease may also trigger NMS • (ECT) with Sux does not appear to trigger the syndrome. • does not seem to be inherited, . • possible due to dopamine depletion in the CNS by psychoactive agents. • bromocriptine, a dopamine agonist, is often useful in treatment of NMS • ↑ with dehydration, rapid titration of triggering drugs, and psychomotor agitation • Other DDx: CNS diseases → meningitis, tumor,