NEUROLEPTIC MALIGNANT SYNDROME: NEED FOR EARLY DIAGNOSIS AND THERAPY
Abstract
Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received littleattention in the clinical settings in Pakistan. The aim of our study was to review the predisposing
factors, outcomes and characteristics of in-patients diagnosed with NMS. Methods: We
performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in
Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data
was collected using a standardized data entry form and statistical analysis was performed using
Epi Info 6, Version 6.02. Results: There were a total of 20 patients diagnosed with NMS (11 male
and 9 female) in our study with a mean age of 46.6±15.9 years. Haloperidol was the most
frequently responsible neuroleptic. Of the 18 patients on a neuroleptic, most developed NMS after
8 weeks of therapy. There were 5 mortalities all of which were associated with septic shock.
Fourteen patients recovered completely from the episode and did not have any neurologic
sequelae. Conclusions: NMS is an important preventable clinical entity. Early diagnosis and
judicious use of antipsychotics is warranted to prevent mortality and heightened morbidity.
Key Words: Neuroleptic malignant syndrome, antipsychotics, predisposing factors
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