UMEM Educational Pearls

Category: Neurology

Title: Neuroleptic Malignant Syndrome

Keywords: neuroleptic malignant syndrome, anti-psychotic medicaiton reactions (PubMed Search)

Posted: 11/25/2009 by Aisha Liferidge, MD (Updated: 4/25/2024)
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  • Neuroleptic Malignant Syndrome (NMS) is a rare, but true neurological emergency which is today associated with much lower mortality given heightened awareness about the condition.
  • It typically initially begins with muscle rigidity resulting in rhabdomyolysis, followed by high fever, and delirium.
  • Always check creatinine phosphokinase (CPK) and white blood cell levels when concerned about NMS, as these typically elevate in response to muscle breakdown.
  • The following mnemonic (FEVER) serves as a reminder of the signs and symptoms associated with NMS:

           F - Fever (anything over 100.4 F counts)

            E - Encephalopathy

           V - Vital signs instability

           E - Enzymes elevation (i.e. CPK)

            R - Rigidity of muscles