Neuroleptic Malignant Syndrome
Neuroleptic malignant syndrome(NMS) is a rare, life-threatening but potentially treatable condition that is most often associated with adverse reactions to antipsychotic drugs. First identified in 1956 with the advent of modern psychiatric medications, the fever, rigidity, elevated enzyme levels, and brain pathology associated with the syndrome has been typically found to have a mortality rate in the 10-15% range.A study described in the April-June, 2007 issue of Neurology India examines the identification, treatment and outcome in fourteen NMS patients admitted to the Neurology department of a large teaching hospital of North India. The cases were detected and treated during a three-year period (May 2000 to April 2003).The incidence of NMS was 1.40/ 1000 patients treated with neuroleptics and mortality rate was 14.28%. Among the medications associated with development of NMS, Haloperidol (parenteral) was implicated as the most common drug for NMS in 57% of patients. An association with coexisting precipitating illness was clearly recorded in 71.4% patients. 85.7% responded to dopaminergic drugs along with supportive treatment and showed partial or complete recovery within 7-14 days. In partial recovery cases, residual deficits were found including Parkinson-like features, depression and excessive sweating (diaphoresis) in a small percentage of patients.
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