Neuropletic Malignant Syndrome - Information

Neuroleptic malignant syndrome (NMS) refers to the combination of hyperthermia, rigidity, and autonomic dysregulation that can occur as a serious complication of the use of antipsychotic drugs. Delay first used the term in 1960, after observing patients treated with high-potency antipsychotics.

Neuroleptic malignant syndrome is the rarest of the neuroleptic induced movement disorders. It is the most serious and represents a neurologic emergency in most cases. It has now been reported to occur with all drugs that effect the central dopaminergic system (including dopamine agonists and levodopa). There's an isolated report of neuroleptic malignant syndrome in a patient on a trycyclic medication. It is likely an idiosyncratic reaction and patients can, if needed, be given the same agent again without recurrence.

Neuroleptic malignant syndrome is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction. In most cases, the disorder develops within the first 2 weeks of treatment with the drug; however, the disorder may develop any time during the therapy period. The syndrome can also occur in people taking anti-Parkinsonism drugs known as dopaminergics if those drugs are discontinued abruptly.

The syndrome is characterized by high fever, stiffness of the muscles, altered mental status (paranoid behavior), and autonomic dysfunction. Autonomic dysfunction alludes to defective operations of the components of the involuntary (autonomic) nervous system, leading to wide swings of blood pressure, excessive sweating and excessive secretion of saliva.

The most widely accepted mechanism by which antipsychotics cause NMS is that of dopamine D2 receptor antagonism. In this widely accepted model, central D2 receptor blockade in the hypothalamus, nigrostriatal pathways, and spinal cord leads to increased muscle rigidity and tremor via extrapyramidal pathways. Hypothalamic D2 receptor blockade results in an elevated temperature set point and impairment of heat-dissipating mechanisms.

The treatment of NMS with drugs that are combined with dantrolene is associated with a prolongation of clinical recovery. Furthermore, treatment of NMS with dantrolene as monotherapy seems to be associated with a higher overall mortality. Therefore, dantrolene does not seem to be the evidence-based treatment of choice in cases of NMS but might be useful if premedication consisted of a neuroleptic monotherapy.

Intravenous fluids should be given to rapidly expand intravascular volume which is depleted due to dehydration, fever shivering, tremors and vasodilation. Crystalloid solutions are preferred.

Cooling measures should be instituted immediately to control
hyperthermia.

Drug therapy starts with discontinuing the neuroleptic. There are a variety of other effective medications that can be used but the two most frequent ones include Dantrolene sodium and bromocriptine (individually or combined). These drugs reduce the mortality and shorten the course of the syndrome. Dantrolene can be given intravenously or orally starting with 2-3 mg per kg doses divided TID up to a total of 10 mg/kg/day. Bromocriptine can be given orally or by NG tube starting with 2.5 mg TID and increasing every 24 hours by 2.5 mg TID until a response is seen or until a maximum dose of 60 mg is achieved.

What is the prognosis?

Early identification of and treatment for individuals with neuroleptic malignant syndrome improves outcome. If clinically indicated, a low potency neuroleptic can be reintroduced very slowly when the individual recovers, although there is a risk that the syndrome might recur. Another alternative is to substitute another class of drugs for the neuroleptic. Anesthesia may be a risk to individuals who have experienced neuroleptic malignant syndrome.

Listed below are more articles related to the above article from the "Disease And Illness" article category.

People interested in the above article "Neuropletic Malignant Syndrome - Information" are also interested in the related articles listed below:

Tummy Ache Help: Fruitful Remedies to Cure Tummy Ache

Tummy ache can arise due to several reasons and conditions. The best thing is, the victims are not required spend much time, effort and money seeing the doctor all the time. There are number of home made and natural remedies can help you to overcome from this painful situation soon.

Understanding Food Poisioning

Food poisoning is an acute gastroenteritis caused by the consumption of a food material or a drink which contains the pathogenic micro organism or their toxins or poisonous chemicals.Food poisoning is common in hostels, hotels, communal feedings, and festivel seasons.

Sleep Hyperhidrosis: Sweating it Out at Night

Sleep hyperhidrosis is the term given to the condition wherein you experience profuse sweating when you sleep at night. Hyperhidrosis, or excessive sweating, usually happens during the day, when the body is all worked out from one's daily activities. However, sleep excess sweat is a rare instance wherein you sweat during the time that your body is practically at rest. People with sleep hyperhidrosis may not experience excessive sweating during the day.

Information On Leaky Gut Syndrome

Leaky gut syndrome in conjunction with autism is still being researched; a number of studies and research are under way to better understand how the syndrome starts, why it can be prevalent in autistic children, and how to treat it. Simply, leaky guy syndrome is the inability of the intestinal wall to keep out large, unwanted molecules. This symptom of autism most often signifies that the intestinal wall has been altered to become permeable. Leaky gut syndrome in autistic children may occur because of increased sensitivity or allergies.

Lyme Disease

Lyme disease is an infection caused by a kind of bacterium (germ) called a spirochete (say: "spy-ro-keet"). The disease is carried by deer ticks (found in the northeastern and north-central United States) and western black-legged ticks (found mostly on the Pacific Coast). These ticks can spread the disease to animals and humans through tick bites. These ticks are typically about the size of a sesame seed.

Causes of Jaundice

Jaundice is a common condition in newborns. It refers to the yellow color of the skin and whites of the eyes caused by an excess of bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells. Jaundice, also referred to as icterus, is the yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment, bilirubin. The yellowing extends to other tissues and body fluids and also may turn the urine dark. Yellowing of only the skin also can be caused by eating too many carrots or drinking too much carrot juice.

Liver Failure

Liver failure can result from any type of liver disorder, including viral hepatitis, cirrhosis, and liver damage from alcohol or drugs such as acetaminophen. Symptoms partly depend on the type and the extent of liver disease. In many cases, there may be no symptoms. Signs and symptoms that are common to a number of different types of liver disease include...