Neuroleptic Malignant Syndrome - Medtick
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Neuroleptic Malignant Syndrome

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?
  • Increased or labile blood pressure?
  • 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).

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