Neuroleptic malignant syndrome: clinical features, differential diagnose and treatment

Objective. The authors, reviewing the clinic, the differential diagnosis and treatment, report successful clinical case of neuroleptic malignant syndrome (MNS) induced by injection of long-acting forms of haloperidol, which showed clas­sic feature of NMS including muscular ri­gidity and fever.

Method: case report.

Results. A 19-year-old woman with mental retardation and suffering from paranoid schizophrenia developed NMS while was treated by inj ection of long- act­ing forms of haloperidol. Our patient was hospitalized of the stage (full syndrome) when the differential diagnosis was very difficult. Patient recovered under treat­ment with electroconvulsive therapy (ECT), benzodiazepines and Quetiapine.

Conclusions. Neuroleptic malig­nant syndrome (NMS) is an idiosyncratic reaction to neuroleptics, although rare, but serious, life-threatening condition, therefore number of diagnostic problems arises. NMS patients because of the pre­vailing somatic symptoms often primar­ily get attention of the therapeutic profile professionals. The syndrome mortality is up to 30 percent. The successful outcome depends on of the rapid detection of this syndrome and complete treatment.

In summary - pharmacotherapy, unfortunately, is not always effective, therefore the most important and eftec - tive treatment of the ECT. This is espe­cially important when it is impossible to distinguish PNS from lethal (febrile) catatonia, but in both cases the ECT re­mains central to effective treatment.

Keywords: neuroleptic malignant syn­drome, catatonia, ECT, antipsychotics, haloperidol, electroconvulsive therapy.