Neuroleptic Malignant Syndrome (NMS) is a rare but potentially life-threatening medical condition that can occur in individuals who are taking or have recently discontinued the use of certain antipsychotic medications, also known as neuroleptics. NMS is characterized by a combination of symptoms that affect the central nervous system and autonomic nervous system, resulting in severe muscle rigidity, high fever, altered mental status, and autonomic dysfunction.
The onset of NMS is typically rapid and can occur within hours to days after the initiation or dose increase of a neuroleptic medication. The exact cause of NMS is not fully understood, but it is believed to result from a disruption of the balance between dopamine and other neurotransmitters in the brain. The excessive blockade of dopamine receptors in the central nervous system is thought to play a central role in the development of NMS.
The symptoms of NMS include severe muscular rigidity, high body temperature (hyperthermia), altered mental status (such as confusion, agitation, or delirium), autonomic dysfunction (such as fluctuating blood pressure and heart rate), and abnormalities in laboratory tests such as elevated creatine kinase levels. If not recognized and treated promptly, NMS can lead to complications such as renal failure, respiratory failure, and in some cases, death.
Management of NMS involves the immediate discontinuation of the offending neuroleptic medication and supportive care to stabilize vital signs and manage complications. Medications such as muscle relaxants and dopamine agonists may be used to alleviate muscle rigidity and restore the balance of neurotransmitters. Close monitoring and intensive care are often required in severe cases of NMS. With early recognition and appropriate treatment, the prognosis of NMS is generally favorable, although it can take several days to weeks for
