title: Neuroleptic malignant syndrome. Patient with unique clinical and physiologic features.
abstract: Lethargy, marked muscle weakness and rigidity, a maximal temperature of 40 degrees C, and a maximal creatine kinase value of 17,240 IU/liter developed in a 36-year-old woman following treatment with several neuroleptics. Initial treatment with dantrolene was unsuccessful. The patient's condition improved gradually over a 10-day period with no specific therapy. Muscle biopsy revealed a contracture pattern diagnostic of malignant hyperthermia susceptibility, as well as abnormal sensitivity to fluphenazine. This report may be the first description of a patient with neuroleptic malignant syndrome in whom muscle biopsy response similar to that seen in malignant hyperthermia occurred and documents that dantrolene is not uniformly successful therapy for this syndrome.
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009132:Muscles / Q000201:enzymology / Q000648:ultrastructure; D012008:Recurrence
chemical_list: D014150:Antipsychotic Agents; D003402:Creatine Kinase