Neuroleptic Malignant Syndrome: A Rare, Life Threatening Idiosyncratic Drug Reaction

Abstract

Neuroleptic Malignant Syndrome (NMS) is an idiosyncratic reaction to neuroleptic antipsychotic drugs that work on central dopaminergic receptors. The typical symptoms of NMS are fever, decreased consciousness, rigidity, and autonomic disorders that arise when the patient takes neuroleptics. With an incidence of 0.01% - 3.2% of patients using neuroleptic drugs NMS is a rare condition, but has a high mortality rate (5-20%) Management includes stopping the causative agent, supportive therapy aimed at lowering the temperature and management of complications due to NMS. We report our patient, a 49 year old man with symptoms of high fever, decreased consciousness and rigidity, with a history of using aripiprazole, a neuroleptic antipsychotic drug, supporting evidence of muscle damage (CK 25,451 U/L) and Acute Kidney Injury (BUN/Cr). : 142/7.16), hyperthermia to 41.3 degrees was controlled on the second day of treatment, NMS war succesfully managed at 14th day, with the muscle damage parameter returned to normal (CK 188 U/L). Patient shows signs of sepsis and died at 19th day of treatment because of sepsis and multiorgan failure. Early recognition of NMS, aggressiveness in treating hyperthermia is very essential and can reduce morbidity or mortality due to NMS.