• The Korean Journal of Pain
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• v.4 no.1
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• pp.60-63
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• 1991

The neuroleptic malignant syndrome (NMS) is an uncommon but dangerous complication of treatment with neuroleptic drugs. This syndrome is characterized by autonomic dysfunction, extrapyramidal dysfunction, and hyperthermia. NMS seems more frequent with parenteral neuroleptic use. We report a patient in whom suspicious NMS was developed in the ward after epidural administration of 2.5mg of droperidol with morphine for postoperative pain control. Extrapyramidal symptoms and autonomic dysfunction were treated with diazepam, but temperature was spontaneously decreased after 16 hours and 40 minute after receiving epidural droperidol.

• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.138-141
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• 1998

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine $D_2$ receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.107-109
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• 2005

Neuroleptic malignant syndrome is a serious complication of levodopa withdrawal in patients with Parkinson's disease. We report a patient with advanced parkinsonism who developed neuroleptic malignant syndrome in setting of withdrawal of levodopa intake.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.193-200
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• 2001

This is a case report that dysautonomia and catatonia are accompanied by Akinetic Mutism in a 28 year old patient whose symptoms, seemed to catatonic schizophrenia. This study is aimed to assist about comprehension, diagnosis and treatment of dysautonomia and catatonia are accompanied by Akinetic Mutism, because this case is not common. This patient's chief complains that hyperhidrosis, muscular rigidity, akinesia etc are seemed to Neuroleptic Malignant Syndrome. Neuroleptic Malignant Syndrome is a side effect during taking antipsychotic that unknowned high, fever, stupor, muscular rigidity, akinesia, tachycardia, hyperhidrosis, salivation. We cannot rule out Neuroleptic Milignant Syndrome, but this case is seemed to catatonic schizophrenia. The symptoms of catatonic schizophrenia is that prodrome(relaxed concern, ataraxy, lacked concentration) is progressed and akinesia, mutism, ankylosis, stupor etc, are appeared. Oriental medicine, environment with more objective study and treatment are needed.

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.136-145
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• 1997

We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino acid neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Controversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagonists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.249-252
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• 2023

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.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.267-270
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• 2009

Neuroleptic malignant syndrome (NMS) is a rare, but a potentially life threatening condition associated with the use of antipsychotics. The most frequent signs and symptoms of NMS include fever, muscle rigidity, autonomic dysfunction such as tachycardia, tachypnea, and labile blood pressure. Acute complications of NMS include disseminated intravascular coagulation, sepsis, seizure, myocardial infarction, acute renal failure due to rhabdomyolysis and death. We report a rare case of acute renal failure due to rhabdomyolysis associated with neuroleptic malignant syndrome.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.1
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• pp.13-20
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• 2013

Neuroleptic malignant syndrome (NMS) is a severe iatrogenic complication of treatment with antipsychotic medication. The aim of this review is to provide the clinical characteristics and treatments of children and adolescents with NMS. Searches were conducted in Medline, Korean studies Information Service System (KISS), and Research Information Service System (RISS). Sixteen case reports and two review articles were selected in Medline, and two Korean cases reported in department of emergency medicine and pediatrics were selected from RISS. Heterogeneous and atypical presentations of NMS were observed in children and adolescents. Some noticeable differences were observed between adult patients and child patients with NMS. In addition, symptom presentations related to atypical antipsychotic agents differed from those of typical ones. In treatment, bromocriptine and benzodiazepine were recommended for management of symptoms. In particular, electroconvulsive therapy (ECT) was a useful treatment option. For prevention and early detection of NMS in children and adolescents, evaluation of risk factors and understanding of diagnostic features of NMS are very important.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.247-252
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• 1998

Neuroleptic malignant syndrome(NMS) is an acute, potentially fatal, idiosyncratic reaction to neuroleptic medication. Early recognition and intensive care are crucial. An important issue is whether NMS will recur after initial recovery and subsequent use of neuroleptic medication. The authors presented with a male adolescent who had suffered a bipolar disorder manic episode and been taking clozapine after recovering from MNS. He had been admitted into a psychiatric ward once before and similarly diagnosed. On the second admission, he showed muscle rigidity, autonomic instability, mild fever, severe diaphoresis, and altered mental status on the fourth hospital day following a haloperidol injection. He was diagnosed with NMS, according to the clinical signs and laboratory data. After the use of antipsychotics was discontinued, he was moved to intensive care unit and given dantrolene. His condition began to improve about 48 hours after the onset of NMS. Due to manic behavior, he returned to the psychiatric ward. On the 21 st hospital day, clozapine was administered to counter the manic symptoms. The final dose was 350mg and showed good remission signs without further recurrence of NMS.

• YAKHAK HOEJI
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• v.52 no.4
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• pp.288-292
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• 2008

Olanzapine, an atypical antipsychotic, has been widely used for the treatment of schizophrenia and bipolar disease. Although olanzapine is less associated with extrapyramidal symptoms and neuroleptic malignant syndrome compared to existing typical antipsychotics, the use of this drug has a problematic side effect of weight gain, which may cause metabolic syndrome such as type 2 diabetes. However, there are few hospitals practicing body weight monitoring of the patients on olanzapine or other atypical antipsychotics. The goal of this study was to identify the incidence and severity of weight gain associated with the use of the drug in Korea. We performed body weight monitoring of the patients who were on the drug in a hospital setting. Mean of the weight gain (as of one-month-transformation) was 4.33 and 3.39 kg for the male and female patients, respectively. The incidence in the young patients was higher than that observed in the old patients, and the severity was the highest in patients in their thirties followed by twenties or younger. This result suggests that the pattern of the weight gain associated with the use of olanzapine in Korea is similar to the reports performed and documented in US and European countries. Therefore, it appears that healthcare professionals in Korea should also watch on the weight gain issue in patients who are on olanzapine or other atypical antipsychotics.