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Neuroleptic syndrome

Muhammad Zaidi, Kurt Brown, Aquanette Brown, Dominique Neptune, Vicenzio-Holder Perkins
A 46 year old Caucasian male veteran with a mental health history of Bipolar Disorder was admitted to the inpatient psychiatric unit following an episode of mania. He was re-started on his outpatient medication regimen for mood stabilization with Quetiapine, Lamotrigine, and Clonazepam. He improved initially, however, on hospital Day 3, the veteran was noted to have acute worsening of manic and psychotic symptoms including, decreased need for sleep, excess energy and responding to internal stimuli. Additionally, he developed symptoms which were atypical for mania, including unprovoked agitation, depersonalization, difficulty sustaining attention, and visual hallucinations...
February 2019: CNS Spectrums
Roland van Rensburg, Eric H Decloedt
Neuroleptic malignant syndrome is a rare, idiosyncratic emergency associated with exposure to dopamine antagonists, commonly antipsychotic drugs. The typical clinical picture consists of altered consciousness, muscular rigidity, fever, and autonomic instability. While the condition has generally been well described, the pathophysiology is still poorly understood. The importance of this case report is to highlight the lack of robust evidence-based treatment for this emergency. We submit an approach to the pharmacotherapy of neuroleptic malignant syndrome based on the available evidence...
February 15, 2019: Psychopharmacology Bulletin
Saki Manabe, Hidetaka Yanagi, Hideki Ozawa, Atsushi Takagi
A 65-year-old Japanese woman with Parkinson's disease, later diagnosed with Lewy body disease, presented with a 2-day history of systemic tremors. She also had fever without rigidity or creatine kinase (CK) elevation. She was diagnosed with sepsis caused by pyelonephritis with acute kidney injury and parkinsonism exacerbation. Although antibiotic and fluid therapy improved her pyuria and renal function, her fever and tremors persisted. On the fourth day, her symptoms worsened and resulted in cardiopulmonary arrest; however, quick resuscitation allowed the return of spontaneous circulation...
February 28, 2019: BMJ Case Reports
S C Kaliora, I M Zervas, G N Papadimitriou
Electroconvulsive therapy (ECT) is the oldest among the early biological treatments introduced in psychiatry, and the only one still in use. In this paper we attempt a brief presentation of ECT usage over the last 80 years, since it was originally introduced. It is a safe, well-tolerated, and highly effective treatment option for major psychiatric disorders, such as mood disorders and schizophrenia, especially when there is an acute exacerbation of psychotic symptoms or if catatonic symptoms are prominent. ECT has also been used successfully for the treatment of Parkinson's disease, delirium, neuroleptic malignant syndrome, autism and agitation and depression in demented patients...
October 2018: Psychiatrikē, Psychiatriki
John M Kane, Christoph U Correll, Nicholas Delva, Srihari Gopal, Adam Savitz, Maju Mathews
No abstract text is available yet for this article.
March 2019: Journal of Clinical Psychopharmacology
Aleksandra Kotlinska-Lemieszek, Pål Klepstad, Dagny Faksvåg Haugen
CONTEXT: Most patients with advanced malignant disease need to take several drugs to control symptoms. This treatment raises risks of serious adverse effects and drug-drug interactions (DDIs). OBJECTIVES: To identify studies reporting clinically significant DDIs involving medications used for symptom control, other than opioids used for pain management, in adult patients with advanced malignant disease. METHODS: Systematic review with searches in Embase, MEDLINE and the Cochrane Central Register of Controlled Trials, from the start of the databases (Embase from 1980) through 21st June 2018...
February 15, 2019: Journal of Pain and Symptom Management
Vivian Ngo, Alfredo Guerrero, David Lanum, Michelle Burgett-Moreno, Gregory Fenati, Steven Barr, Michael M Neeki
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication resulting from neuroleptic drug therapy. Presentation of NMS can vary, and diagnosis relies primarily upon medical history and symptomatology. Due to the potential delay in diagnosis, emergency physicians should remain vigilant in recognizing the symptoms of NMS and be prepared to initiate immediate treatment following diagnosis. Dantrolene, which has been used for spasticity and malignant hyperthermia, has been reported as a potential treatment for NMS and led to off-label use for NMS...
February 2019: Clinical Practice and Cases in Emergency Medicine
Ibidunni Olapeju Oloniniyi, Adesanmi Akinsulore, Olutayo Olubunmi Aloba, Boladale Moyosore Mapayi, Olakunle Ayokunmi Oginni, Roger Makanjuola
Objective: This study evaluated the economic cost of schizophrenia in Nigerian patients and identified factors that influence cost. Methods: A total of 100 participants with schizophrenia were assessed using the modified economic cost questionnaire, the mini-international neuropsychiatric interview, the positive and negative syndrome scale, the Liverpool University Neuroleptic side-effect rating scale, and the global assessment of functioning scale. Associations between sociodemographic characteristics, illness-related variables and direct, indirect, and total costs of schizophrenia were assessed...
January 2019: Journal of Neurosciences in Rural Practice
Suraj Rajan, Bonnie Kaas, Emile Moukheiber
Many acute and potentially life-threatening medical conditions have hyperkinetic or hypokinetic movement disorders as their hallmark. Here we review the clinical phenomenology, and diagnostic principles of neuroleptic malignant syndrome, malignant catatonia, serotonin syndrome, Parkinsonism hyperpyrexia, acute parkinsonism, acute chorea-ballism, drug-induced dystonia, and status dystonicus. In the absence of definitive lab tests and imaging, only a high index of clinical suspicion, awareness of at-risk populations, and variations in clinical presentation can help with diagnosis...
February 2019: Seminars in Neurology
Byung-Chul Son, Joong-Seok Kim, Woo-Chan Park, Hak-Cheol Ko
Although deep brain stimulation (DBS) has been used for > 25 years in the treatment of movement disorders, no report has been published on the management of DBS pulse generators implanted in the anterior chest in patients with breast cancer who require mastectomy, radiotherapy, and future imaging studies.We describe a 62-year-old female patient with advanced Parkinson's disease (PD) who was dependent on bilateral subthalamic nucleus (STN) DBS. She was diagnosed with cancer in her left breast. To avoid difficulties in imaging studies, surgery, and radiotherapy related to the breast cancer, bilateral pulse generators for STN DBS previously implanted in the anterior chest wall were repositioned to the anterior abdominal wall with replacement of long extension cables...
February 1, 2019: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Nicola Germain, Steven Kymes, Elin Löf, Jakubowska Anna, Clément François, James H Weatherall
AIMS: There have been no systematic literature reviews (SLRs) evaluating the identified association between outcomes (e.g. clinical, functional, adherence, societal burden) and Quality of Life (QoL) or Healthcare Resource Utilization (HCRU) in schizophrenia. The objective of this study was to conduct a SLR of published data on the relationship between outcomes and QoL or HCRU. MATERIALS AND METHODS: Electronic searches were conducted in Embase and Medline, for articles which reported on the association between outcomes and QoL or HCRU...
January 30, 2019: Journal of Medical Economics
Sergio Alejandro Gómez-Ochoa, Blanca Beatriz Espín-Chico, Gabriel David Pinilla-Monsalve, Bonnie M Kaas, Luis Ernesto Téllez-Mosquera
Hyperglycemia-associated chorea-ballism (HCB) is an infrequent neurological syndrome occurring predominantly in elderly females and in the setting of non-ketotic hyperglycemia (NKH). A systematic review was conducted in accordance with the PRISMA statement. Studies published between 1980 and 2018 that reported demographic, clinical, laboratory and imaging features from patients with HCB were screened. 136 studies describing 286 patients were included in the analysis. The patients included had a median age of 72 years; those with ketotic hyperglycemia (KH) were older (p<0...
October 2018: Functional Neurology
Sean Nutting, Christopher Martin, Richard Prensner, Andrew Francis, Alfredo Bellon
Wolff-Parkinson-White syndrome (WPW) is a cardiac conduction abnormality characterized by ventricular contractions that appear sooner than the usual interval regulated by the atrioventricular (AV) node. It is commonly asymptomatic but in rare cases can lead to sudden cardiac death. Little is known about the cardiac effects of antipsychotics on patients with WPW. Here we review all the published information currently available on the use of neuroleptics in patients with this cardiac conduction anomaly. Only a few case reports and one controlled study have been published in this area...
January 3, 2019: Clinical Schizophrenia & related Psychoses
Mosaad Almegren
Venous thromboembolism is one of the complications in patients prescribed antipsychotic medications. Neuroleptic malignant syndrome (NMS) is a rare side effect of antipsychotic medications in this population. In this case, a young patient, who presented with NMS after a recent start of antipsychotic medications, had developed a pulmonary embolism despite standard of care measures of venous thromboprophylaxis and early mobilization. A low threshold of VTE suspicion and effective preventive measures are both required in order to avoid this preventable complication in this population...
November 6, 2018: Hematology Reports
Laura Maffeis, Robertino Dilena, Sophie Guez, Francesca Menni, Cristina Bana, Silvia Osnaghi, Giorgio Carrabba, Paola Marchisio
BACKGROUND: Idiopathic intracranial hypertension (IIH), also known as pseudotumour cerebri syndrome (PTCS), is characterized by the presence of signs and symptoms of raised intracranial pressure without evidence of any intracranial structural cause and with normal cerebrospinal fluid microscopy and biochemistry. Obesity, various systemic diseases and endocrine conditions, and a number of medications are known to be risk factors for PTCS. The medications commonly associated with PTCS are amiodarone, antibiotics, corticosteroids, cyclosporine, growth hormone, oral contraceptives, vitamin A analogues, lithium, phenytoin, NSAIDs, leuprolide acetate, and some neuroleptic drugs...
January 5, 2019: BMC Pediatrics
Peter I Agbonrofo, John E Osakue
Background: Neuroleptic malignant syndrome is a rare but life-threatening idiosyncratic complication following the use of antipsychotic agents, anaesthesia and surgery. It is characterized by hyperthermia, muscle rigidity, autonomic disturbances and mental state alterations. Case: A 31 year old female weighing 60kg received a depot preparation of Fluphenazine on account of depression with psychotic features observed two days prior to elective Cholecystectomy under general anaesthesia...
September 2018: African Health Sciences
Sandeep Grover, Ashirbad Sathpathy, Sai Chaitanya Reddy, Sahil Mehta, Navneet Sharma
Parkinsonism-hyperpyrexia syndrome (PHS) is a rare but potentially life-threatening complication of the management of Parkinson's disease (PD). Central hypodopaminergic state which results due to abrupt withdrawal of dopaminergic medications in patients with PD is the postulated cause. Clinical manifestations of PHS are very akin to neuroleptic malignant syndrome (NMS). Here, we report a case of a 60-year-old male with 13-year history of PD, who was on Levodopa (300 mg) + Carbidopa (75 mg). On abrupt stoppage of Levodopa (300 mg) + Carbidopa (75 mg), he presented with symptoms akin to NMS, with raised creatine kinase...
October 2018: Indian Journal of Psychiatry
Harsh Sahu, Mouna Bidarguppe Manjunath, Animesh Ray, Naval Kishore Vikram
Neuroleptic malignant-like syndrome is a rare but potentially fatal complication of sudden withdrawal of dopaminergic drugs. Clinical features are similar to that of neuroleptic malignant syndrome (NMS) like hyperthermia, autonomic dysfunction, altered sensorium, muscle rigidity; but instead of history of neuroleptic use, there is history of withdrawal of dopaminergic drugs. Laboratory examination generally show elevated creatine phosphokinase levels and may show elevated total leucocyte count. Thrombocytopaenia has been very rarely reported with NMS but it has not been reported with NM-like syndrome...
December 3, 2018: BMJ Case Reports
Rani A Sarkis, M Justin Coffey, Joseph J Cooper, Islam Hassan, Belinda Lennox
OBJECTIVE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterized by prominent neuropsychiatric symptoms. Given the nature of its pathophysiology, psychiatrists tend to be one of the first clinicians encountering patients with the disease. METHODS: In the present review of patients described in the literature with psychiatric symptoms, the authors aimed to characterize the psychiatric symptoms of the disease and its management in adults and adolescents as well as children (≤12 years old)...
December 18, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
Michael Schneider, Johannes Regente, Timo Greiner, Stephanie Lensky, Stefan Bleich, Sermin Toto, Renate Grohmann, Susanne Stübner, Martin Heinze
Neuroleptic malignant syndrome (NMS) is a rare, but severe adverse drug reaction of drugs with anti-dopaminergic properties. The main symptoms are fever and rigor. In addition, other symptoms such as creatine kinase elevation, alteration of consciousness and various neurological symptoms may occur. A total of 52 NMS cases have been documented in the drug safety program 'Arzneimittelsicherheit in der Psychiatrie' from 1993 to 2015. We calculated incidences and analyzed imputed substances and additional risk factors to study the impact of changing therapy regimes...
November 30, 2018: European Archives of Psychiatry and Clinical Neuroscience
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