Disease relevance of Neuroleptic Malignant Syndrome

• Sudden death in cocaine abusers: relation to neuroleptic malignant syndrome [1].
• OBJECTIVE: The author's goal was to develop a pathophysiological model for neuroleptic malignant syndrome with greater explanatory power than the alternative hypotheses of hypothalamic dopamine antagonism (elevated set point) and direct myotoxicity (malignant hyperthermia variant) [2].
• A 45-year-old woman with Parkinson's disease developed neuroleptic malignant syndrome (NMS) despite lack of levodopa withdrawal [3].
• Two schizophrenic patients developed muscular rigidity, stupor, and hyperpyrexia consistent with neuroleptic malignant syndrome, 8 to 10 days after starting haloperidol therapy [4].
• Rhabdomyolysis and coma associated with amisulpride: a probable atypical presentation of neuroleptic malignant syndrome [5].

Psychiatry related information on Neuroleptic Malignant Syndrome

• The authors describe a patient with dopa-responsive dystonia who developed neuroleptic malignant syndrome with prolonged catatonia following treatment with neuroleptic agents [6].
• 1. Haloperidol is a drug used in the management of several psychotic disorders and its use has been linked to Neuroleptic Malignant Syndrome [7].
• Additional clinical findings (ie, fever, mutism, agitation, dystonia, akathisia, elevated creatine kinase, and increased leukocyte count) were similar to those of neuroleptic malignant syndrome [8].
• Until now, only three patients with Huntington's disease (HD) and a neuroleptic malignant syndrome (NMS) have been reported in the literature [9].
• The authors report a case of a patient, who in a few days after an abrupt discontinuation of clozapine and haloperidol developed agitated and confused state resembling neuroleptic malignant syndrome (NMS) and clozapine withdrawal symptoms at the same time [10].

High impact information on Neuroleptic Malignant Syndrome

• Risperidone and neuroleptic malignant syndrome [11].
• Neuroleptic malignant syndrome. Successful treatment with pancuronium [12].
• Neuroleptic malignant syndrome after venlafaxine [13].
• Treatment of neuroleptic malignant syndrome with dantrolene [14].
• Successful treatment of neuroleptic malignant syndrome with sodium nitroprusside [15].

Chemical compound and disease context of Neuroleptic Malignant Syndrome

• A patient with chronic schizophrenia treated with fluphenazine developed neuroleptic malignant syndrome, characterized by fever, obtundation, rigidity, and tremulousness [16].
• Haloperidol in neuroleptic malignant syndrome [17].
• Dopamine agonists and neuroleptic malignant syndrome [18].
• Unlike other investigators, the authors found that young adulthood, nonschizophrenic illness, oral high-potency neuroleptics, and concurrent use of lithium were not important risk factors for neuroleptic malignant syndrome [19].
• Further work is needed to establish the diagnostic criteria, incidence, and predisposing factors, to identify the role of 5-HT antagonists in treatment, and to differentiate the syndrome from neuroleptic malignant syndrome [20].

Biological context of Neuroleptic Malignant Syndrome

• CYP2D6 genotype and possible susceptibility to the neuroleptic malignant syndrome [21].
• The aim of this study was to identify the effectiveness of clonidine in the recovery of patients with neuroleptic malignant syndrome and autonomic dysfunction, including blood pressure lability [22].
• The unsatisfactory treatment of tardive syndromes, neuroleptic malignant syndrome, and cocaine-induced neurologic disease underscores our incomplete understanding of the neurochemistry of dopamine, the function of newly discovered dopamine receptors, and the role they play in maintaining normal emotional and motoric function [23].
• Within these three categories, this review discusses the epidemiology, risk factors, clinical features and treatment of acute dystonic reactions, drug-induced parkinsonism, neuroleptic malignant syndrome, serotonin syndrome, acute akathisia, and the tardive syndromes [24].
• CYP2D6 gene deletion allele in patients with neuroleptic malignant syndrome: preliminary report [25].

Anatomical context of Neuroleptic Malignant Syndrome

• Homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) levels in the cerebrospinal fluid (CSF) were determined twice in nine cases of neuroleptic malignant syndrome (NMS) during the active phase [26].
• CONCLUSION: caution must be exercised when prescribing alimemazine, especially to children with basal ganglia damage and in the case of inexplicable fever and restlessness, neuroleptic malignant syndrome should be considered [27].
• Risperidone, neuroleptic malignant syndrome and probable dementia with Lewy bodies [28].
• Familiarity with the syndrome, baseline laboratory values including creatine phosphokinase, lactate dehydrogenase, serum glutamicoxaloacetic transaminase, and complete blood cell count with a differential count, and a high index of suspicion are of the utmost importance in making the diagnosis of neuroleptic malignant syndrome [29].

Gene context of Neuroleptic Malignant Syndrome

• Mutation analysis of the ryanodine receptor gene isoform 3 (RYR3) in recurrent neuroleptic malignant syndrome [30].
• Lack of association between neuroleptic malignant syndrome and polymorphisms in the 5-HT1A and 5-HT2A receptor genes [31].
• CONCLUSIONS: The authors cannot conclude that polymorphisms in the 5-HT1A and 5HT2A receptor genes are factors determining susceptibility to the neuroleptic malignant syndrome [31].
• Our previous study has suggested that the TaqI A polymorphism of dopamine D2 receptor gene (DRD2) is associated with the predisposition to neuroleptic malignant syndrome (NMS) [32].
• Some studies have shown that in neuroleptic malignant syndrome (NMS), associated with disseminated intravascular coagulation (DIC), the serum level of tumor necrosis factor alpha (TNF-alpha) increases significantly, which is thought to trigger the onset of DIC [33].

Analytical, diagnostic and therapeutic context of Neuroleptic Malignant Syndrome

• Intravenous injection of levodopa is more effective than dantrolene as therapy for neuroleptic malignant syndrome [34].
• In those patients in whom it is difficult to differentiate between serotonin and neuroleptic malignant syndromes, the physical examination may be helpful:clonus and hyperreflexia are more suggestive of serotonin syndrome,whereas lead-pipe rigidity is suggestive of NMS [35].
• Differential diagnosis between neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) could not be accurately determined because of the overlap of signs and symptoms of both syndromes [36].
• To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) - a rare but potentially life-threatening complication of neuroleptic therapy - 4 days after treatment with risperidone was initiated [37].
• CONCLUSION: Diatrizoate, which has been incriminated in most adverse reactions resulting from the inadvertent intrathecal injection of a contrast material, may produce symptoms similar to those of the neuroleptic malignant syndrome by blocking neurotransmission through dopamine receptors [38].

References