[ neuroleptic malignant syndrome]

ABSTRACT

This is one of the serious complications that can occur at any time during treatment with neuroleptics. Its prevalence is estimated at 0.01% - 0.02% in patients treated with neuroleptics. Patient aged 19 years hospitalized in psychiatry for schizophreniform disorder and put on haloperidol 15 mg / day chlorpromazine 200 mg / day. Fifteen days after admission, he shozed gradually generalized muscle rigidity, difficulty walking and fatigability. All operating in a context of confusion and hyperthermia at 38.5[degree sign] C. determination of CPK was 2396 IU / l. Given this clinical picture, the diagnosis of neuroleptic malignant syndrome was made and the neuroleptic treatment was stopped and the patient put under massive diazepam with rehydration and strict clinical supervision. The clinical and biological evolution was favorable, and he was put under Olanzapine. The patient was young. Neuroleptic malignant syndrome occurred two weeks after the introduction of neuroleptic treatment with haloperidol [15 mg / day] and chlorpromazine [200 mg / day]. The clinical picture is limited to generalized muscle rigidity, confusion, hyperthermia at 38.5 and elevated CPK [2396 UI / l]. Stopping the treatment in question, correction of fluid and electrolyte disorders and prescription of a benzodiazepine conduct to a favorable evolution two weeks later. A practitioner should suspect a neuroleptic malignant syndrome before unexplained hyperthermia in a patient under neuroleptic. Immediate discontinuation of neuroleptic therapy and general measures of resuscitation is the mainstay of treatment