Journal of Medical and Surgical Intensive Care Medicine 2011 , Vol 2, Issue 3
Three Patients with Neuroleptic Malignant Syndrome: Differential Diagnosis and the Causes of Predisposition
Ali Kemal Kadiroğlu 1 , Berat Ebik 2 , Ömer Kaya 2 , Serdar Yıldırım 2 , Yasin Bez 3
1Dicle Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı, Diyarbakır, Türkiye
2Dicle Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Diyarbakır, Türkiye
3Dicle Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Diyarbakır, Türkiye
DOI : 10.5152/dcbybd.2011.15

Neuroleptic malignant syndrome  (NMS) is a life-threatening idiosyncratic reaction that occurs after the administration of neuroleptic drugs. It usually appears within the first two weeks of neuroleptic treatment. The tetrad of NMS seen in 50% of patients includes fever, muscle rigidity, altered mental status and evidence of autonomic instability. NMS may be overlooked or its diagnosis may be difficult due to its similarities with some organic and psychiatric disorders. Due to its heterogeneous character, differential diagnosis and supportive treatment are very important when managing these patients. We aimed to present the differential diagnosis and the causes of predisposition in three patients, two with a diagnosis of schizophrenia and one with psychomotor impairment, who were admitted to the medical intensive care unit with a diagnosis of an NMS-like condition related to antipsychotic (olanzapine) treatment. 

Keywords : Neuroleptic malignant syndrome, pre-renal ARF, vitamin B12 deficiency, hypernatremia, psychomotor impairment