Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Management of a trauma patient with alcohol withdrawal who developed neuroleptic malignant syndrome in Korea: a case report

  • Byungchul Yu (Department of Trauma Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Ji Yeon Lee (Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Yong Beom Kim (Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Hee Yeon Park (Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Junsu Jung (Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Youn Yi Jo (Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine)
  • Received : 2022.08.29
  • Accepted : 2022.11.17
  • Published : 2023.09.30
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Abstract

Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7℃ after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.

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References

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