Diagnosis and implications in the therapeutic management of patient with afebrile neurolepctic malignant syndrome.
This report aims at raising clinical awareness for the diagnosis of atypical presentations of neuroleptic malignant syndrome (NMS). We describe the case of a female patient with NMS symptoms, except fever, after starting the use of chlorpromazine. The afebrile condition delayed the consideration of NMS by the emergency clinicians who provided her initial assessment. Before this consideration, an anticholinergic agent, not recommended at this condition, was inadvertently prescribed. This might have contributed to the worsening of symptoms. NMS is a life-threatening idiosyncratic reaction most often seen as complication of antipsychotic treatment. Its clinical spectrum is broad and its diagnosis should be considered even if the patients do not fulfill all the possible described symptoms.
Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp) , Rua Tessália Vieira de Camargo , 126, Campinas 13083-894, Brazil.
Rafael Quintes Ducasble
RQ
Gomes
Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp) , Rua Tessália Vieira de Camargo , 126, Campinas 13083-894, Brazil.
Amilton
A
Dos Santos-Júnior
Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp) , Rua Tessália Vieira de Camargo , 126, Campinas 13083-894, Brazil.
Gabriel Augusto de Araujo Silva
GA
Dias
Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp) , Rua Tessália Vieira de Camargo , 126, Campinas 13083-894, Brazil.
Carlos Filinto da Silva
CF
Cais