Reconsidering Rigidity in the Diagnosis of Neuroleptic Malignant Syndrome: A Case Report.

Journal of Psychiatric Practice
Rhea El KhourySami Richa

Abstract

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal syndrome classically encountered in patients receiving typical antipsychotic agents. However, many physicians have also reported the occurrence of NMS with atypical antipsychotics, notably with atypical presentations. In this report, we present a case in which a patient's antipsychotic regimen during a psychotic episode (which involved both typical and atypical antipsychotics) subsequently led to NMS. During his stay, the patient developed an altered level of consciousness, elevation of creatine phosphokinase, hemodynamic instability, and a fever. However, the patient did not have signs of rigidity, the cardinal sign of this syndrome. The authors concluded that patients could develop NMS without rigidity while receiving an antipsychotic. Given this presentation, the authors suggest that clinicians have a high level of suspicion for NMS to avoid misdiagnosis and subsequent adverse consequences. Hence, clinicians must be vigilant about atypical presentations of NMS without rigidity.

References

Oct 1, 1985·The American Journal of Psychiatry·J L Levenson
Oct 1, 1986·The American Journal of Psychiatry·H G PopeS L McElroy
Sep 15, 1998·Psychiatric Services : a Journal of the American Psychiatric Association·A L PeloneroA K Pandurangi
Jun 2, 2009·CNS Drugs·Julian N TrollorPerminder S Sachdev
Jan 1, 2011·The Neurohospitalist·Brian D Berman
Aug 1, 2015·Neurocritical Care·Sumul ModiPanayiotis Varelas
Sep 29, 2015·Current Neuropharmacology·Lurdes TseFidel Vila-Rodriguez
Jul 18, 2016·The Annals of Pharmacotherapy·Dominic J Pileggi, Aaron M Cook
May 10, 2019·Asian Journal of Psychiatry·Favaz VellekkattVikas Menon
Jul 13, 2019·General Hospital Psychiatry·Kartik SinghaiNaresh Nebhinani

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here