[Clinical study of neuroleptic malignant syndrome in demented patients--examination of our case and reported cases].
Recently, some cases of neuroleptic malignant syndrome (NMS) in demented patients have been reported, because the demented patients, who were administered neuroleptics due to their abnormal behaviors, have increased. We also experienced an 85-year-old male demented patient with NMS. His NMS was induced by haloperidol and disappeared by quitting the neuroleptic and a water supply. The post-NMS relapse of his abnormal behavior was ameliorated by a kind of herbal medicine "Ohren-Gedoku-Toh". We attempted to grasp the clinical characteristics of NMS in dementia by investigating the present case and reported cases. As the result, the following characteristics are suggested, (1) the NMS in dementia was seen more in vascular dementias than in Alzheimer's diseases, (2) in all the cases, the drug to be responsible to NMS was haloperidol, (3) a walking difficulty appeared at even the pre-stage or early stage of NMS, (4) the administration of dantrolene and/or bromocriptine was necessary to treat the patients with a high temperature. Moreover, examining our case, Levenson's criteria for NMS which regards a high serum CPK may be clinically more useful in the diagnosis of the NMS in dementia, because an early diagnosis and treatment can be done according to the criteria.
Kimura
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T
Division of Clinical Research, National Kikuchi Hospital, Kumamoto, Japan.
Yoshida
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H
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications*; D015140:Dementia, Vascular / Q000150:complications; D005260:Female; D006220:Haloperidol / Q000009:adverse effects* / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*
D006220:Haloperidol; C006820:bromperidol