Emergent neuroleptic hypersensitivity as a herald of presenile dementia.
Neuroleptic hypersensitivity is characteristic of dementia with Lewy bodies (DLB) but not of other dementias. The authors report 5 patients with psychotic mood disorders and long-standing antipsychotic drug therapy. As they reached 50 to 60 years of age, they unexpectedly developed hypersensitivity to these medications, with rigidity, muteness, or the neuroleptic malignant syndrome. Nearly coincident with this reaction, they developed progressive cognitive deficits consistent with frontotemporal dementia. These patients illustrate emergent neuroleptic hypersensitivity as an early manifestation of other dementias. The predisposition to neuroleptic hypersensitivity could result from depleted nigral dopaminergic neurons suggested by "smudging" of the substantia nigra pars compacta on magnetic resonance imaging.
Mendez
M F
MF
Department of Neurology, University of California at Los Angeles School of Medicine, Los Angeles 90073, USA. mmendez@ucla.edu
Lipton
A
A
D000544:Alzheimer Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D014150:Antipsychotic Agents / Q000009:adverse effects*; D004298:Dopamine / Q000172:deficiency; D004342:Drug Hypersensitivity / Q000150:complications*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D009474:Neurons / Q000378:metabolism; D012720:Severity of Illness Index; D013378:Substantia Nigra / Q000378:metabolism / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology
D014150:Antipsychotic Agents; D004298:Dopamine