title: Neuroleptic malignant syndrome in a patient with tongue cancer: a report of a rare case.
abstract: Background. Neuroleptic malignant syndrome (NMS) is a rare but life-threatening complication of neuroleptic drugs, which are used widely in head and neck cancer (HANC) patients who develop delirium. Methods and Results. Postoperative delirium in a 39-year-old man with tongue cancer was treated with haloperidol and chlorpromazine. Three days after the first administration of antipsychotics, the patient exhibited elevated body temperature, autonomic and extrapyramidal symptoms, and impaired consciousness. A definitive diagnosis was made using the research diagnostic criteria for NMS in the DSM-IV, and the antipsychotics were immediately discontinued. The patient was given dantrolene and bromocriptine to treat the NMS. The patient's hyperthermia, elevated creatinin kinase (CK), and muscle rigidity improved gradually, with all symptoms of NMS resolving completely by 13 days after the diagnosis. Conclusions. HANC surgeons must be alert for early signs of NMS and use antipsychotics conservatively to avoid NMS and its potentially fatal outcome.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Ibaraki, Tsukuba City 305-8575, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Baba
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamagata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tomidokoro
authors.forename: Akira
authors.initials: A
authors.lastname: Tamaoka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Itoh
authors.forename: Toru
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Kojiro
authors.initials: K
authors.lastname: Onizawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Bukawa