Atypical Neuroleptic Malignant Syndrome: Pitfalls and Challenges in the Delirious Substance Abuser  

作　　者：Nirav N. Shah Kristin G. Fless Mikhail Litinski Fariborz Rezai Paul C. Yodice Henry Rosenberg 

机构地区：[1]Department of Medical Education and Clinical Research, St. Barnabas Medical Center, Livingston, USA [2]Department of Surgery and Critical Care Medicine, St. Barnabas Medical Center, Livingston, USA

出　　处：《Open Journal of Anesthesiology》2012年第2期53-57,共5页麻醉学期刊（英文）

摘　　要：Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.

关 键 词：ATYPICAL NEUROLEPTIC Malignant Syndrome HALOPERIDOL ZIPRASIDONE DANTROLENE Rhabdomyolysis Creatinine Phosphokinase AMINOTRANSFERASE 

分 类 号：R5[医药卫生—内科学]