J Neuropsychiatry Clin Neurosci 1992; 4:265-269
Copyright © 1992 by American Neuropsychiatric Association
Distinguishing neuroleptic malignant syndrome (NMS) from NMS-like acute medical illnesses: a study of 34 cases
DD Sewell and DV Jeste
San Diego VA Medical Center, CA.
A study of 34 hospitalized patients with suspected neuroleptic malignant
syndrome (NMS) found that 24 had NMS and the other 10 had acute, usually
serious, medical problems. There were no demographic, psychopathologic, or
treatment-related differences between the groups. NMS patients had more
dehydration, cogwheeling, diaphoresis, disorientation, drooling, dysphagia,
and rigidity and higher diastolic blood pressure. The groups had similar
fevers, heart rates, creatine kinase levels, and white blood cell counts.
Three non-NMS patients died during their acute illnesses. Results suggest
that considering NMS as a diagnosis and ruling out other acute illnesses
such as pneumonia are equally important when a patient on neuroleptic
medication becomes medically ill.
