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Neuroleptic Malignant Syndrome or Catatonia? A Case Report Cover

Neuroleptic Malignant Syndrome or Catatonia? A Case Report

Open Access
|Aug 2020

Abstract

Introduction

A review of the literature has shown that there are many similarities in the presentation of neuroleptic malignant syndrome (NMS) and catatonia. Attempts to reconcile the differences have been made by suggesting that NMS and catatonia may represent different presentations of the same illness or that they lie within the same spectrum of a poorly understood clinical syndrome. The described case is of a patient who presented with NMS and catatonia which was difficult to diagnose, but which responded to treatment with intravenous diazepam.

Case presentation

The case concerns a 22-year-old male admitted for pulmonary hypertension to an intensive care unit (ICU). Three days following admission, he developed a high fever that did not respond to antibiotics. The patient then developed rigidity, nocturnal agitation, decreased responsiveness, and somnolence. Without the use of bromocriptine (Novartis, Basel, Switzerland) or dantrolene (Par Pharmaceuticals, Chestnut Ridge, USA) discontinuation of neuroleptics combined with intravenous diazepam (Pfizer, NY, USA) led to a very rapid response and marked improvement in the case.

Conclusions

Early recognition and management of NMS and MC in a complex, gravely ill patient, may be accomplished in the ICU despite obfuscation of traditional signs and symptoms of the NMS and MC syndrome. Such interventions can have life-saving effects on patients in danger of fatal autonomic instability.

DOI: https://doi.org/10.2478/jccm-2020-0025 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 190 - 193
Submitted on: May 2, 2020
Accepted on: Jun 27, 2020
Published on: Aug 11, 2020
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2020 Sebastian Rodriguez, Keith A. Dufendach, Robert M. Weinreib, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.