PDF(Pubmed)
Abstract：
UNASSIGNED: Neuroleptic malignant syndrome (NMS), a rare but potentially life-threatening adverse reaction to treatment with antipsychotic drugs, is characterized by hyperthermia, muscle rigidity, impaired consciousness, and autonomic disturbances. Some reports have described rapidly progressing cases of NMS resulting in death within several days. This report describes a clinical course of fatal and fulminant NMS in a patient with schizoaffective disorder.
UNASSIGNED: A 67-year-old man had long been in a stable condition under antipsychotic pharmacotherapy. At 3 days before admission to our hospital, he complained of diarrhea, fatigue, and reduced appetite. On admission to our hospital, he showed fever, mild muscle rigidity at the four extremities, elevated heart rate, hypertension, excessive diaphoresis, and decreased percutaneous oxygen saturation (SpO2). He was diagnosed as having NMS. Within 3 days after the onset of NMS, he displayed severe hyperthermia up to 41.4°C and severe autonomic disturbances, including elevated heart rate and hypertension. Despite treatments with dantrolene and bromocriptine, he went into shock and died on the fourth day after admission.
UNASSIGNED: The present case suggests that severe hyperthermia and severe autonomic disturbances at the early stage of the onset might be signs of fatal and fulminant NMS. It may be recommended that clinicians consider electro-convulsive therapy when treating fulminant NMS with these symptoms.
UNASSIGNED: A 67-year-old man had long been in a stable condition under antipsychotic pharmacotherapy. At 3 days before admission to our hospital, he complained of diarrhea, fatigue, and reduced appetite. On admission to our hospital, he showed fever, mild muscle rigidity at the four extremities, elevated heart rate, hypertension, excessive diaphoresis, and decreased percutaneous oxygen saturation (SpO2). He was diagnosed as having NMS. Within 3 days after the onset of NMS, he displayed severe hyperthermia up to 41.4°C and severe autonomic disturbances, including elevated heart rate and hypertension. Despite treatments with dantrolene and bromocriptine, he went into shock and died on the fourth day after admission.
UNASSIGNED: The present case suggests that severe hyperthermia and severe autonomic disturbances at the early stage of the onset might be signs of fatal and fulminant NMS. It may be recommended that clinicians consider electro-convulsive therapy when treating fulminant NMS with these symptoms.
摘要：
■抗精神病药恶性综合征（NMS），抗精神病药物治疗的罕见但可能危及生命的不良反应，以高热为特征，肌肉僵硬，意识受损，和自主神经紊乱。一些报告描述了NMS迅速发展的病例，导致几天内死亡。该报告描述了分裂情感障碍患者的致命和暴发性NMS的临床过程。
■一名67岁的男子在抗精神病药物治疗下长期处于稳定状态。入院前3天，他抱怨腹泻,疲劳,食欲下降。一入院，他表现出发烧，四肢轻度肌肉僵硬,心率升高,高血压,过度出汗,和降低经皮氧饱和度（SpO2）。他被诊断为患有NMS。NMS发病后3天内,他表现出高达41.4°C的严重高温和严重的自主神经紊乱，包括心率升高和高血压.尽管用丹曲林和溴隐亭治疗，他在入院后第四天休克死亡。
■目前的情况表明，在发病的早期，严重的高热和严重的自主神经紊乱可能是致命和暴发性NMS的迹象。可能建议临床医生在治疗具有这些症状的暴发性NMS时考虑电惊厥治疗。
■一名67岁的男子在抗精神病药物治疗下长期处于稳定状态。入院前3天，他抱怨腹泻,疲劳,食欲下降。一入院，他表现出发烧，四肢轻度肌肉僵硬,心率升高,高血压,过度出汗,和降低经皮氧饱和度（SpO2）。他被诊断为患有NMS。NMS发病后3天内,他表现出高达41.4°C的严重高温和严重的自主神经紊乱，包括心率升高和高血压.尽管用丹曲林和溴隐亭治疗，他在入院后第四天休克死亡。
■目前的情况表明，在发病的早期，严重的高热和严重的自主神经紊乱可能是致命和暴发性NMS的迹象。可能建议临床医生在治疗具有这些症状的暴发性NMS时考虑电惊厥治疗。
