A 'benign' extrapyramidal side effect masking a life-threatening neuroleptic malignant syndrome

Reinhard Dolp; Moin Ahmed Ansari; Michael Chan; Tariq Hassan

doi:10.12669/pjms.36.6.2963

A 'benign' extrapyramidal side effect masking a life-threatening neuroleptic malignant syndrome

Pak J Med Sci. 2020 Sep-Oct;36(6):1429-1432. doi: 10.12669/pjms.36.6.2963.

Authors

Reinhard Dolp¹, Moin Ahmed Ansari², Michael Chan³, Tariq Hassan⁴

Affiliations

¹ Dr. Reinhard Dolp, Resident Physician, Postgraduate year 3, Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
² Dr. Moin Ahmed Ansari, FCPS. Head of the Department of Psychiatry, Liaqat University of Medical & Health Specialities, Hyderabad, Pakistan.
³ Dr. Michael Chan, FRCPC. Assistant Professor, Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
⁴ Dr. Tariq Hassan, FRCPC (Forensic Psychiatry). Associate Professor, Head of Forensic Psychiatry, Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.

Abstract

The neuroleptic malignant syndrome is a rare, life-threatening idiosyncratic reaction to neuroleptic medication. The use of newer antipsychotics combined with its rare incidence has made NMS seem as a complication of the past. Here we report a patient in his early 20s suffering from a psychotic disorder developing a life-threatening neuroleptic malignant syndrome on an inpatient psychiatric ward in Canada without the characteristic overt change in autonomic stability. We review the clinical characteristics to facilitate the early recognition of neuroleptic malignant syndromes and discuss why this condition still is highly relevant for practising physicians.

Keywords: Antipsychotics; EPSE; Extra-pyramidal side effects; NMS; Neuroleptic malignant syndrome; Neuroleptics.

Publication types

Case Reports