Neuroleptic malignant syndrome: two cases without muscle rigidity.
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.
Wong
M M
MM
Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong.
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
D014150:Antipsychotic Agents