Neuroleptic Malignant Syndrome (NMS) is a life-threatening complication of anti-psychotic medication therapy.
While NMS is rare (0.02 to 2.44% amongst those taking neuroleptic drugs), its associated mortality (up to 12%) and morbidity (i.e. rhabdomyolysis, pneumonia, seizures, renal failure, disseminated intravascular coagulation (DIC), respiratory failure) are severe.
Historically, there has been little consensus about universally accepted diagnostic criteria for NMS, until an expert panel of various physician specialists recently convened and determined the following criteria:
- Exposure to dopamine agonist or dopamine agonist withdrawal within past 72 hours - Hyperthermia - Rigidity - Mental status alteration - Elevated creatinine phosphokinase - Sympathetic nervous system lability (2 or more of the following: elevated blood pressure, fluctant blood pressure, urinary incontinence, diaphoresis) - Tachycardia and tachypnea - Negative work-up for infectious, metabolic, neurologic, or toxic etiologies.
Treatment includes immediate withdrawal of any antipsychotic medication and is, otherwise, largely supportive.
References
The Neuroleptic Malignant Syndrome Information Service. International Expert Panel Consensus on Diagnostic Criteria for NMS.
