Published: 2021-12-23

Neuroleptic malignant syndrome: case report

Murshid C. P., Bande Shareef, Parlapalli Hema


Neuroleptic malignant syndrome (NMS) is an infrequent, but potentially life-threatening neurologic emergency associated with the use of neuroleptic or antipsychotic drugs. A 43 years old male with a history of trigeminal neuralgia developed Neuroleptic malignant syndrome while receiving Carbamazepine and Amitryptylline. Treatment is mainly supportive and includes withdrawal of the neuroleptic medication and, possibly, administration of drugs such as dantrolene and bromocriptine. Complications of NMS include acute renal failure and acute respiratory failure. The possible etiologies, triggering factors and treatment are discussed with reference to existing literature.


Neuroleptic malignant syndrome, Dopamine receptor, Creatinine kinase, Hyperpyrexia, Sarcoplasmic reticulum

Full Text:



Adnet P, Lestavel P, Krivosic-Horber R. Neuroleptic malignant syndrome. Br J Anaesth. 2000;85(1):129-35.

Delay J, Deniker P. Drug-induced extrapyramidal syndromes. In: Vinken DJ, Bruyn GW, editors. Handbook of clinical neurology. Amsterdam: North-Holland Publishing. 1968;248-66.

Myers RD. Neurochemistry of thermoregulation: two negatives make a positive. Brain Res Bull. 1999;50(5,6):453-4.

Toru M, Matsuda O, Makaguchi K. Neuroleptic malignant syndrome-like state following a withdrawal of antiparkinsonian drug. J Nerv Ment Dis. 1981;169:324-7.

Tollefson G. A case of neuroleptic malignant syndrome: in vitro muscle comparison with malignant hyperthermia. J Clin Psychopharmacol. 1982;2:266-70.

Adnet PJ, Krivosic-Horber RM, Adamantidis MM, Haudecoeur G, Adnet-Bonte CA, Saulnier F, et al. The association between the neuroleptic syndrome and malignant hyperthermia. Acta Anaesthesiol Scand. 1989;33:676-80.

Pelonero AL, Levenson JL, Pandurangi AK. Neuroleptic malignant syndrome: a review. Psychiatr Serv. 1998;49(9):1163-72.

Pope HG, Keck PE, McElroy SL. Frequency and presentation of neuroleptic malignant syndrome in a large psychiatric-hospital. Am J Psychiatry. 1986;143(10):1227-33.

Bond WS. Detection and management of the neuroleptic malignant syndrome. Clin Pharm. 1984;3:302-7.

Neuropsychiatric Disease and Treatment. 2011;13:161-75.

Adnet P, Lestavel P, Krivosic-Horber R. Neuroleptic malignant syndrome. Br J Anaesth. 2000;85(1):129-35.

Neuropsychiatric Disease and Treatment. 2017;13:161-75.

Rosenberg MR, Green M. Neuroleptic malignant syndrome: Review of Response to Therapy. Arch Intern Med. 1989;149:1927-31.

Henderson VW, Wooten GF. Neuroleptic malignant syndrome: Pathogenetic role for dopamine receptor blockade? Neurology. 1981;31:132-7.

Kuchibatla SS, Cheema SA, Chakravarthy KS. A case report of neuroleptic malignant syndrome. Case Reports. 2009;2009:bcr0720080429.

Bhanushali MJ, Tuite PJ. The evaluation and management of patients with neuroleptic malignant syndrome. Neurologic Clin. 2004;22(2):389-411.

Strawn JR, Keck PE, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry. 2007;164(5):870-6.

Rosenberg MR, Green M. Neuroleptic malignant syndrome - review of response to therapy. Arch Internal Med. 1989;149(9):1927-31.

Sakkas P, Davis JM, Janicak PG, Wang ZY. Drug-treatment of the neuroleptic malignant syndrome. Psychopharmacol Bull. 1991;27(3):381-4.

Neuroleptic Malignant Syndrome Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association. 1994;739-42.