NMS

Neuroleptic Malignant Syndrome – also known as NMS is a disorder that affects the neurological system and it can be life threatening. It is most often seen as an adverse reaction to medications –  neuroleptic or antipsychotic drugs.

Dopaminergic receptors in the brain are believed to be blocked.

It can result in a change of the 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 – FEVER

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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