What is it?
Rare, but life-threatening unexplained reaction to neuroleptic medications that is presented by fever, muscular rigidity, altered mental status, and autonomic dysfunction (functions of the body that are done in a controlled fashion).
Diagnosis Tests
- The key to diagnosis is that it occurs only after exposure to an neuroleptic drug.
- On average, onset is 4-14 days after the start of therapy
- 90% of cases occur within 10 days.
- However it can occur years into therapy.
- Once the syndrome starts, it usually evolves over 24-72 hours.
Cause
- Often occurs shortly after the initiation of neuroleptic medication/treatment or after a dose increase.
- Defect in the receptors to dopamine (dopamine D2 receptor antagonism)
Symptoms
-
Severe muscular rigidity (low reflex response as well, others may present high reflex response)?
-
Hyperthermia-Temperature greater than 38°C (100°F)?
-
Changes in the level of consciousness?
- Muscular rigidity (typically, “lead pipe” rigidity)?
- Hyperthermia (temperature >38°C)?
- Diaphoresis (sweating)?
- Pale appearance?
- Dysphagia (difficulty swallowing)?
- Dyspnoea (difficulty breathing)?
- Incontinence?
- Tremor?
- Shuffling gait (strange movement when walking or posture)?
- Psychomotor agitation (irritated , anxiety and/or depressed – change of behaviour)?
- Delirium (confusion) progressing to lethargy, stupor, coma?
Other general examination findings indicative of autonomic dysregulation include the following:
-
Diaphoresis (sweating)?
-
Sialorrhea (excess saliva production)?
-
Tachycardia (fast heart beat)?
-
Tachypnoea, respiratory distress (31% of cases) – abnormal rapid breathing?
-
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Hypoxemia (low pulse oximeter reading)- low oxygen saturation levels?
Oxygen saturation levels (using an oximeter)
- Scale 1 : Normal oxygen levels are 94- 98%
- Scale 2 Chronic obstructive pulmonary disease (long term breathing condition) oxygen levels are 88-92%
Complications /Information to beware of/General tips:
Medical Emergency Condition
Do not wait, phone for an ambulance
This condition can lead to:
This condition may show similar symptoms to:
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Neuroleptic Malignant Syndrome in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
- NHS
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- Medscape
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- Pharmaceutical Journal
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- WebMD
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- Drugs.com
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- National Organisation of Rare Diseases
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- Verywell Health
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