title: [The neuroleptic malignant syndrome (NMS). A report of a clinical case with a protracted and recurrent course. A review of the literature].
abstract: Neuroleptic malignant syndrome (NMS), characterized by catatonic behavior, generalized muscular rigidity, hyperthermia and autonomic dysfunction, can suddenly arise in patients treated with neuroleptic agents and carries a high mortality rate even today. A case of NMS due to i.m. therapy with haloperidol decanoate is reported in this paper, characterized by sustained course and a severe relapse due to a different therapy with another neuroleptic agent. The patient however, after a prolonged remission from the relapse, was able to resume long term therapy with neuroleptic drugs. The importance of monitoring blood levels of CPK during the follow-up and the effectiveness of therapy with bromocriptine and dantrolene in confirmed. Although the patient presented a good clinical response, she developed permanent cerebral and muscular damage. A wide review of the literature on NMS is reported to throw light on this syndrome, whose recognition and prompt diagnosis are necessary to reduce mortality.
authors.affiliation: Divisione di Medicina II, Azienda Ospedaliera, Istituti Ospitalieri, Cremona.
authors.forename: A
authors.initials: A
authors.lastname: Marelli
authors.forename: P
authors.initials: P
authors.lastname: Bodini
authors.forename: P
authors.initials: P
authors.lastname: Dizioli
authors.forename: G
authors.initials: G
authors.lastname: Chiodelli
authors.forename: M
authors.initials: M
authors.lastname: Guarneri
authors.forename: L
authors.initials: L
authors.lastname: Boldori
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D013997:Time Factors
chemical_list: D014150:Antipsychotic Agents; C033563:haloperidol decanoate; D006220:Haloperidol