Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report
Neuroleptic malignant syndrome is a neurological emergency caused by dysregulation of dopaminergic neurotransmission. While it is typically characterized by muscle rigidity, fever and altered mental status, it may have a heterogeneous and non-specific presentation, leading to delays in diagnosis an...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2021-06-01
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| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13019 |
| _version_ | 1798028230808043520 |
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| author | Ana Maia Gonçalo Cotovio Bernardo Barahona-Corrêa Albino J. Oliveira-Maia |
| author_facet | Ana Maia Gonçalo Cotovio Bernardo Barahona-Corrêa Albino J. Oliveira-Maia |
| author_sort | Ana Maia |
| collection | DOAJ |
| description |
Neuroleptic malignant syndrome is a neurological emergency caused by dysregulation of dopaminergic neurotransmission. While it is typically characterized by muscle rigidity, fever and altered mental status, it may have a heterogeneous and non-specific presentation, leading to delays in diagnosis and treatment. Treatment involves cessation of dopamine-receptor antagonists and supportive measures, but in more severe cases, bromocriptine, dantrolene, benzodiazepines and/or electroconvulsive therapy should be considered. We present the case of a 66-year-old man with severe neuroleptic malignant syndrome, diagnosed due to need for continuous invasive ventilation in an Intensive Care Unit, after successful treatment for respiratory sepsis. The patient recovered after electroconvulsive therapy and administration of bromocriptine. This unusually severe case illustrates the need for a high level of suspicion for neuroleptic malignant syndrome in critically ill patients with malignant catatonic syndromes, allowing for an early diagnosis and potentially lifesaving
treatment.
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| first_indexed | 2024-04-11T19:04:35Z |
| format | Article |
| id | doaj.art-d2df2e024b134eb3a238843bb96ccb6a |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-04-11T19:04:35Z |
| publishDate | 2021-06-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-d2df2e024b134eb3a238843bb96ccb6a2022-12-22T04:07:50ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582021-06-0134610.20344/amp.130195115Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case ReportAna Maia0Gonçalo Cotovio1Bernardo Barahona-Corrêa2Albino J. Oliveira-Maia3Departament of Psychiatry and Mental Health. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. NOVA Medical School | Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Champalimaud Research and Clinical Centre. Champalimaud Centre for the Unknown. Lisboa. b. NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal c. Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unkown, Av. Brasilia 1400-038, Lisboa, PortugalDepartament of Psychiatry and Mental Health. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. NOVA Medical School | Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Champalimaud Research and Clinical Centre. Champalimaud Centre for the Unknown. Lisboa. b. NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal c. Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unkown, Av. Brasilia 1400-038, Lisboa, PortugalDepartament of Psychiatry and Mental Health. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. NOVA Medical School | Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Champalimaud Research and Clinical Centre. Champalimaud Centre for the Unknown. Lisboa. b. NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal c. Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unkown, Av. Brasilia 1400-038, Lisboa, PortugalDepartament of Psychiatry and Mental Health. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. NOVA Medical School | Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Champalimaud Research and Clinical Centre. Champalimaud Centre for the Unknown. Lisboa. b. NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal c. Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unkown, Av. Brasilia 1400-038, Lisboa, Portugal Neuroleptic malignant syndrome is a neurological emergency caused by dysregulation of dopaminergic neurotransmission. While it is typically characterized by muscle rigidity, fever and altered mental status, it may have a heterogeneous and non-specific presentation, leading to delays in diagnosis and treatment. Treatment involves cessation of dopamine-receptor antagonists and supportive measures, but in more severe cases, bromocriptine, dantrolene, benzodiazepines and/or electroconvulsive therapy should be considered. We present the case of a 66-year-old man with severe neuroleptic malignant syndrome, diagnosed due to need for continuous invasive ventilation in an Intensive Care Unit, after successful treatment for respiratory sepsis. The patient recovered after electroconvulsive therapy and administration of bromocriptine. This unusually severe case illustrates the need for a high level of suspicion for neuroleptic malignant syndrome in critically ill patients with malignant catatonic syndromes, allowing for an early diagnosis and potentially lifesaving treatment. https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13019Intensive Care UnitsNeuroleptic Malignant Syndrome/diagnosisNeuroleptic Malignant Syndrome/therapy |
| spellingShingle | Ana Maia Gonçalo Cotovio Bernardo Barahona-Corrêa Albino J. Oliveira-Maia Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report Acta Médica Portuguesa Intensive Care Units Neuroleptic Malignant Syndrome/diagnosis Neuroleptic Malignant Syndrome/therapy |
| title | Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report |
| title_full | Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report |
| title_fullStr | Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report |
| title_full_unstemmed | Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report |
| title_short | Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report |
| title_sort | diagnosis and treatment of neuroleptic malignant syndrome in the intensive care unit a case report |
| topic | Intensive Care Units Neuroleptic Malignant Syndrome/diagnosis Neuroleptic Malignant Syndrome/therapy |
| url | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13019 |
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