A disorder that affects the neurological system of an individual

Most often seen as an adverse reaction to medications specifically 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  –  ususally first symptom
   -     Fever
   -     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.