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Diagnostic uncertainty in a case of neuroleptic malignant syndrome

Published online by Cambridge University Press:  21 May 2015

Dallas P. Seitz
Dallas P. Seitz*
Affiliation:
Department of Psychiatry, Queen's University, Kingston, Ont.
*
Department of Psychiatry, Hotel Dieu Hospital, 166 Brock St., Kingston ON K7L 5G2; 613 544-3310, fax 613 544-7079, seitzd@hdh.kari.net

Abstract

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Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that has been associated with antipsychotic use. Most diagnostic criteria include fever and muscle rigidity, although NMS may present without either. Diagnostic uncertainty in such cases may result in delays in diagnosis and management, leading to adverse consequences for these patients. The differential diagnosis of NMS is broad and includes a number of neurological, medical and psychiatric conditions as well as substance and medication-induced disorders. A case is described that illustrates an atypical presentation of NMS and demonstrates some of the challenges in its diagnosis. Limitations of current NMS criteria are also examined, and suggestions for future criteria are presented.

Keywords

neuroleptic malignant syndromeadverse drug reactionantipsychoticsdifferential diagnosisserotonin syndrome
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 4 , July 2005 , pp. 266 - 272
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

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