title: Anesthetic management of a pediatric patient with neuroleptic malignant syndrome.
abstract: Neuroleptic malignant syndrome (NMS) is a rare disorder which is clinically similar to malignant hyperthermia (MH). It is characterized by hyperthermia, autonomic instability, muscle rigidity, coma, rhabdomyolysis, and acidosis. Without immediate and appropriate therapy, mortality may result. NMS is associated with administration of antipsychotic medications, anti-emetic medications, and changes in the dosage of anti-parkinsonian drugs. As several similarities exist between NMS and MH, differentiating between them can be a challenge for the clinician. We report anesthetic care during magnetic resonance imaging of the brain of a 14-year-old female with bipolar and schizoaffective disorders and the recent onset of NMS.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and the Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA. Tarun.Bhalla@Nationwidechildrens.org
authors.forename: Tarun
authors.initials: T
authors.lastname: Bhalla
authors.forename: Douglas
authors.initials: D
authors.lastname: Maxey
authors.forename: Amod
authors.initials: A
authors.lastname: Sawardekar
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy; D005260:Female; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000503:physiopathology*; D015742:Propofol / Q000008:administration & dosage; D011618:Psychotic Disorders / Q000188:drug therapy
chemical_list: D000777:Anesthetics; D018686:Anesthetics, Intravenous; D014150:Antipsychotic Agents; D015742:Propofol
references.citation: Am J Psychiatry. 1985 Oct;142(10):1137-45
references.pmid: 2863986
references.citation: Hong Kong Med J. 2001 Mar;7(1):101-3
references.pmid: 11406684
references.citation: J Child Adolesc Psychopharmacol. 2009 Aug;19(4):415-22
references.pmid: 19702493
references.citation: Acta Anaesthesiol Scand. 1989 Nov;33(8):676-80
references.pmid: 2588999
references.citation: J Clin Psychiatry. 1980 Mar;41(3):79-83
references.pmid: 6101595
references.citation: J Clin Psychopharmacol. 1982 Aug;2(4):266-70
references.pmid: 6126494
references.citation: Pharmacoepidemiol Drug Saf. 2010 May;19(5):429-35
references.pmid: 20306454
references.citation: Anaesthesia. 1995 Mar;50(3):246-7
references.pmid: 7717493
references.citation: Arch Intern Med. 1989 Sep;149(9):1927-31
references.pmid: 2673115
references.citation: Am J Psychiatry. 2007 Jun;164(6):870-6
references.pmid: 17541044
references.citation: Acta Psychiatr Scand. 1987 Mar;75(3):237-9
references.pmid: 3591405
references.citation: Br J Anaesth. 2000 Jul;85(1):129-35
references.pmid: 10928001
references.citation: J Clin Psychiatry. 1982 Sep;43(9):381-2
references.pmid: 7118846
references.citation: Mov Disord. 2010 Sep 15;25(12):1780-90
references.pmid: 20623765
references.citation: Br J Anaesth. 1987 Dec;59(12):1554-6
references.pmid: 3426910
references.citation: Clin Pharm. 1984 May-Jun;3(3):302-7
references.pmid: 6145537
references.citation: Neurology. 1988 Feb;38(2):297-301
references.pmid: 3340297
references.citation: Hosp Med. 1999 Jun;60(6):448-9
references.pmid: 10492720