NMS

 

 

Neuoleptic Malignant Syndrome – also known as NMS is a disorder that affects the neurological system and it can be life threatening.

Most often seen as an adverse reaction to medications –  neuroleptic or antipsychotic drugs.

Dopaminergic receptors in the brain are believed to be blocked.

Result is a change in Skeletal Muscle causing an increased in heat generation along with difficulty with regulation of temperature.

Increased dosing of medication increases risk on NMS.

Occurs in 0.2% of those taking the above mentioned medications.

Symptoms

  • Muscle rigidity – *** usually one of the first symptoms
  • Fever – *** usually one of the first symptoms
  • Change in blood pressure
  • Mental status changes
  • Confusion
  • Tremors of muscle
  • Visual changes

Mnemonic

F – Fever
E – Encephalopathy
V – Vitals unstable
E – Elevated Enzymes (CPK elevation)
R –  Rigidity of muscles

Treatment

  • This is an emergent medical situation
  • Death is possible without treatment
  • Medication must be stopped initially
  • Hospital visit
  • Hydration
  • Treat for fever
  • –  Ice packs
  • –  Placement in groin, under arms, and chest region
  • Possible need for ventilation

Medication

.  Dantrolene sodium

.  Bromocriptine

.  Apomorphine

.  Benzodiazepines

*** – in some cases when the drug causing this condition is restarted – a recurrence of symptoms may occur – but for the most part it does not.

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