A Case of the Neuroleptic Malignant Syndrome Survived by Intensive Medical Treatments

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Neuroleptic malignant syndrome (NMS) has been reported to occur after the initiation, modification or withdrawal of medications such as psychomimetic and antiparkinsonian drugs. We herein report a case of NMS induced by an increase in the dose of a medication. The patient survived after receiving intensive medical treatments. A 54 year-old female had been treated with a psychomimetic for three years. She acutely presented with hyperthermia and disturbance of consciousness one week after an increase in dose. She was managed with artificial ventilation, continuous hemodiafiltration, and the administration of dantrolene. Her maximum serum CPK level was 42, 550IU/l. She was weaned from the ventilator 10 days later and subsequently recovered from renal failure after 28 days. Fifty-seven days after hospitalization, she was in stable condition and was transferred to the psychiatry department. NMS is an uncommon but serious and potentially lethal drug reaction that should be diagnosed by not only psychiatry but also emergency medical professionals. History of psychiatry medications, physical examination, and blood tests may be obtained to identify potential cases of NMS. Early intensive care such as ventilation and hemodialysis are required if NMS is suspected.
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