NEUROLEPTIC MALIGNANT SYNDROME: NEED FOR EARLY DIAGNOSIS AND THERAPY

Authors

  • Humaira M. Khan
  • Nadir A. Syed
  • Mughis Sheerani
  • Bhojo Khealani
  • Ayeesha Kamal
  • Mohammad Wasay

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 predisposingfactors, outcomes and characteristics of in-patients diagnosed with NMS. Methods: Weperformed a retrospective chart review of all cases (age > 15 years) at a tertiary care center inKarachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Datawas collected using a standardized data entry form and statistical analysis was performed usingEpi Info 6, Version 6.02. Results: There were a total of 20 patients diagnosed with NMS (11 maleand 9 female) in our study with a mean age of 46.6±15.9 years. Haloperidol was the mostfrequently responsible neuroleptic. Of the 18 patients on a neuroleptic, most developed NMS after8 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 neurologicsequelae. Conclusions: NMS is an important preventable clinical entity. Early diagnosis andjudicious use of antipsychotics is warranted to prevent mortality and heightened morbidity.Key Words: Neuroleptic malignant syndrome, antipsychotics, predisposing factors

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