title: Neuroleptic Malignant Syndrome/Malignant Catatonia in Child Psychiatry: Literature Review and a Case Series.
abstract: OBJECTIVE
  To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents.
  
  
  BACKGROUND
  NMS and MC are life-threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent. Some authorities believe that apart from the history of exposure to an AP medication, the two conditions are identical. The symptoms of NMS/MC include severe agitation, behavior disregulation, motor and speech changes, self-injury and aggression, autonomic instability, and a range of psychiatric symptoms (affective, anxiety, or psychotic symptoms). Patients may be misdiagnosed with another disorder leading to extensive tests and a delay in treatment. Untreated, the condition may be fatal in 10%-20% of patients, with death sometimes occurring within days of disease onset.
  
  
  METHODS
  We describe the presentation and management of five children and adolescents with NMS/MC.
  
  
  CONCLUSIONS
  MC and NMS are life-threatening medical emergencies, which if diagnosed promptly, can be successfully treated with known effective treatments (benzodiazepines and/or electroconvulsive therapy).
authors.affiliation: 1 Department of Psychiatry, University of Michigan , Ann Arbor, Michigan.
authors.forename: Neera
authors.initials: N
authors.lastname: Ghaziuddin
authors.affiliation: 2 Henry Ford Health System , Detroit, Michigan.
authors.forename: Melissa
authors.initials: M
authors.lastname: Hendriks
authors.affiliation: 1 Department of Psychiatry, University of Michigan , Ann Arbor, Michigan.
authors.forename: Paresh
authors.initials: P
authors.lastname: Patel
authors.affiliation: 3 Kennedy Kreiger Institute, Baltimore, Maryland.
authors.forename: Lee E
authors.initials: LE
authors.lastname: Wachtel
authors.affiliation: 4 Department of Psychiatry, University of Mississippi Medical Center , Jackson, Mississippi.
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Dhossche
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D002389:Catatonia / Q000175:diagnosis*; D002648:Child; D002665:Child Psychiatry; D004565:Electroconvulsive Therapy / Q000379:methods; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D016728:Self-Injurious Behavior
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines
keywords: adolescents; children; malignant catatonia (MC); neuroleptic malignant syndrome (NMS)