1/13. neuroleptic malignant syndrome associated with olanzapine.OBJECTIVE: The aim of the present paper is to report a case of neuroleptic malignant syndrome (NMS) occurring 2 days after olanzapine was added to the treatment regimen of an elderly patient with Schizoaffective Disorder. The patient had a previous history of NMS associated with risperidone. CLINICAL PICTURE: Two days after commencement of olanzapine, the patient presented in a stuporous state with dysarthria and increased muscle tone with cogwheeling. His level of consciousness fluctuated over the following 24 h with worsening rigidity, the onset of a mild fever, tachycardia and elevated blood pressure. Biochemical screening revealed markedly elevated creatine kinase. TREATMENT: Olanzapine was ceased and intravenous fluid replacement commenced. Hourly physical observations were instigated, as was regular serum monitoring of creatine kinase level. OUTCOME: Over the subsequent 48 h, there was gradual clinical improvement with resolution of dysarthria, ataxia, rigidity and fever. The patient was returned to the psychiatric ward 3 days after his admission to the medical ward. CONCLUSIONS: Olanzapine therapy can be associated with NMS. To our knowledge, there are no previous reports of this in the literature.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/13. neuroleptic malignant syndrome induced by haloperidol following traumatic brain injury.The use of neuroleptics in the acute management of traumatic brain injury (TBI) is controversial and may be detrimental to recovery. The following case report describes a patient developing neuroleptic malignant syndrome (NMS) secondary to the use of haloperidol given to control the patient's agitation. The patient began to exhibit symptoms consistent with NMS (high fever, dystonia, diaphoresis, tachycardia, and decerebrate posturing) shortly after administration of the haloperidol. Upon transfer to a rehabilitation hospital, the symptoms persisted. When NMS is suspected, the first intervention is to remove the offending agent; thus, the administration of haloperidol was suspended, and the patient was placed on amantadine and propranolol. amantadine was used to increase the availability of dopamine to the mid-brain region, and the propranolol was used to control the fever, which was believed to be central in origin. The patient was able to complete his rehabilitation with no further incidence of fever or agitation. The patient met or exceeded all short-term physical therapy goals and was able to complete most of the neuropsychological tasks presented. The patient returned home 38 days after admission to the rehabilitation hospital and was able to perform most activities of daily living. At the 6-months follow-up visit, the patient was considering entrance into an adult vocational school.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/13. neuroleptic malignant syndrome: a diagnosis easily missed.A woman admitted with psychotic depression developed a number of physical problems. urinary incontinence, headache, neck stiffness and breathing difficulties were all treated separately but were later found to be part of the neuroleptic malignant syndrome. Treatment of the disorder led to complete recovery. We review the criteria for diagnosis of this serious disorder and some differential diagnoses.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/13. neuroleptic malignant syndrome: a case report.neuroleptic malignant syndrome (NMS) is a controversial, relatively rare and potentially fatal drug side effect which occurs with the use of neuroleptics and other drugs that adversely affect the dopamine system. To our knowledge there has been no previous report on NMS from ethiopia. We present a case here and stress the need for early detection of this potentially fatal condition. The case is a 14 year old manic patient who while under inpatient treatment at Amanuel Hospital between November 19, 1997 and February 13, 1998 exhibited fever, muscular rigidity, autonomic instability and some laboratory evidences of muscular destruction which are said to be typical features of NMS. The patient was receiving chlorpromazine until four days prior to the onset of the symptoms when haloperidol was added. There was no other physical condition by which these clinical features could be explained. The symptoms resolved within 2 weeks by simple drug withdrawal and supportive treatment.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/13. neuroleptic malignant syndrome due to olanzapine.neuroleptic malignant syndrome (NMS) is a rare and potentially fatal complication precipitated by the use of antipsychotic medications, most notably haloperidol. Criteria previously described include: exposure to the neuroleptic class of medications; hyperthermia; muscle rigidity; a cluster of laboratory and physical findings that may include mental status changes, autonomic instability, creatine phosphokinase elevation and leukocytosis, and exclusion of other causes for the patient's condition. A prodrome of mental status changes, autonomic instability, tremors, diaphoresis, excess salivation, and extrapyramidal signs may precede NMS. Prior reports of NMS linked to olanzapine have been in patients who had been previously treated with other neuroleptic agents or in patients who had previous episodes of NMS precipitated by other neuroleptics. Several cases included patients treated with olanzapine in addition to another neuroleptic. This report describes a case of NMS associated with olanzapine in a patient who had not previously been exposed to the neuroleptic drug class. At the time this patient presented, there were no reports in the literature of NMS associated with olanzapine alone. Treatment of NMS includes: immediate withdrawal of all neuroleptics; supportive care; fever control; management of autonomic instability (tachycardia, tachypnea, blood pressure fluctuations); and pharmacologic management with dantrolene and bromocriptine.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/13. neuroleptic malignant syndrome.neuroleptic malignant syndrome is a life-threatening reaction of neuroleptic medication. The estimated incidence rate of neuroleptic malignant syndrome is between 1% and 1.5% of patients treated with neuroleptics. The reported mortality rate varies from 11% to 38%. risk factors include younger males (80% less than 40 years) and physical disability. Although 80% of neuroleptic malignant syndrome cases develop within the first 2 weeks of treatment, the syndrome can develop anytime during the therapy period. The clinical picture and laboratory findings are not always unique. Less than 50% of cases manifest with classical symptoms. Deaths usually result from cardiovascular collapse. Renal failure, pulmonary emboli, aspiration pneumonia, and respiratory failure are also reported. Familiarity with the syndrome, baseline laboratory values including creatine phosphokinase, lactate dehydrogenase, serum glutamicoxaloacetic transaminase, and complete blood cell count with a differential count, and a high index of suspicion are of the utmost importance in making the diagnosis of neuroleptic malignant syndrome. A judicial choice of neuroleptic medication and careful observation of patients may reduce the incidence, morbidity, and mortality of neuroleptic malignant syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/13. brain injury following neuroleptic malignant syndrome: case report and review of the literature.OBJECTIVE: To report a case of brain injury following neuroleptic malignant syndrome (NMS) and review the literature for similar documented cases. CASE REPORT: A 30-year old woman presented to the ER with psychotic features and was treated with several anti-psychotics. Subsequently, she developed neurological symptoms and was diagnosed with neuroleptic malignant syndrome. Following a prolonged course in an acute care facility, she was admitted to a rehabilitation ward, where cognitive and physical examinations revealed significant findings. These included marked dysarthria, difficulties comprehending commands, attention problems, as well as abnormalities in her muscle tone, power, reflexes, gait, co-ordination and sensory function. CONCLUSION: literature reviews reveal few documented cases of brain injury following neuroleptic malignant syndrome. A further exploration of the effects of NMS on the brain is warranted to elicit whether cerebellar damage is indeed common following neuroleptic malignant syndrome. Such research could eventually lead to therapeutic interventions aimed at preventing permanent brain injury in persons with NMS.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/13. neuroleptic malignant syndrome in organic brain disease and physical illness.The neuroleptic malignant syndrome is a serious complication associated with the use of antipsychotic drugs that has received a great deal of interest in recent times. Although its aetiology has not been fully understood, it often occurs in association with underlying brain disease and physical debilitation. Two such cases are described. The various hypotheses concerning the aetiology and pathogenesis of this condition are also discussed.- - - - - - - - - - ranking = 5keywords = physical (Clic here for more details about this article) |
9/13. neuroleptic malignant syndrome.neuroleptic malignant syndrome is a rare but serious adverse effect of antipsychotic medication. The author describes three new cases and reviews 50 others published in the past 5 years. Demographic and clinical features, diagnosis, treatment, outcome, and pathophysiology are critically reviewed, and a new set of diagnostic criteria, incorporating physical signs and routine laboratory tests, is proposed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/13. neuroleptic malignant syndrome following amoxapine overdose.The case of a patient who developed the neuroleptic malignant syndrome following an overdose of amoxapine is presented. It is suggested that amoxapine, an antidepressant structurally related to the neuroleptic loxapine, be added to the list of medications that can cause this potentially lethal syndrome. This case illustrates the need for careful evaluation and attention to differential diagnosis when psychiatric patients develop physical signs and symptoms.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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