Faculty Collaboration Database

Neuroleptic malignant syndrome: physiological and laboratory findings in a series of nine cases. J Clin Psychiatry 1987 Aug;48(8):328-33

Date

08/01/1987

Pubmed ID

2886491

Scopus ID

2-s2.0-0023618786 (requires institutional sign-in at Scopus site)   55 Citations

Abstract

A series of nine cases of neuroleptic malignant syndrome (NMS) are presented with peak measures of autonomic dysfunction and laboratory findings. Urine abnormalities, consisting of proteinuria, casts, or cells, were an associated finding in these cases. Severe hypophosphatemia was present in two patients. Relative dehydration before the onset of the syndrome in eight of the nine patients supports the suggestion that it is a risk factor for the development of NMS. The withdrawal of dopamine agonists was also seen as a trigger for NMS. Autonomic instability and muscular rigidity occurred separately in some cases. Creatine phosphokinase elevation and fever did not necessarily parallel the duration or the degree of muscular rigidity, and this finding supports the idea of a central cause for the symptoms. A systematic approach is presented for the evaluation and treatment of NMS. Observations implicate central dopaminergic mechanisms in the regulation of autonomic functioning and the maintenance of peripheral muscle membrane stability.

Author List

Harsch HH

Author

Harold H. Harsch MD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Antipsychotic Agents
Autonomic Nervous System
Basal Ganglia
Blood Pressure
Body Temperature
Creatine Kinase
Dehydration
Dopamine
Fluid Therapy
Humans
Hypothalamus
Leukocyte Count
Male
Mental Disorders
Middle Aged
Neuroleptic Malignant Syndrome
Parasympatholytics