What is the neuroleptic malignant syndrome (NMS)?
Neuroleptic Malignant Syndrome presents with the cardinal features of hyperthermia, rigidity, autonomic instability, and altered consciousness in the setting of a markedly elevated CK level and recent exposure to a triggering agent.
Delirium, mutism, dysphagia, tremor, and dysautonomia can occur.
NMS is most often associated with use of either typical or atypical neuroleptics. However, it can be seen with other anti-dopaminergic drugs such as metoclopramide and promethazine as well as with an abrupt withdrawal of pro-dopaminergic drugs such as levodopa and dopamine agonists.
Treatment includes discontinuation of the offending agent, aggressive hydration, and initiating therapy with either bromocriptine or dantrolene.
