title: Neuroleptic malignant syndrome: two cases without muscle rigidity.
abstract: OBJECTIVE
  Two patients with neuroleptic malignant syndrome without muscle rigidity are described.
  
  
  METHODS
  Both patients developed fever and altered consciousness while taking neuroleptic but did not develop muscle rigidity; the symptoms subsided when the neuroleptic was stopped but recurred when it was given again.
  
  
  METHODS
  The neuroleptic was stopped; one patient received supportive treatment and the other received bromocriptine.
  
  
  RESULTS
  One patient died while the other survived.
  
  
  CONCLUSIONS
  The pathophysiology is proposed as a combination of involvement of the central thermoregulatory, neuroregulatory and autonomic nervous systems, and the peripheral skeletal muscle. It supports the concept of a spectrum of clinical severity of neuroleptic malignant syndrome.
authors.affiliation: Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: M M
authors.initials: MM
authors.lastname: Wong
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006212:Hallucinations / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D009127:Muscle Rigidity / Q000139:chemically induced / Q000175:diagnosis; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis*; D009460:Neurologic Examination / Q000187:drug effects; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents