Adopting a Local Protocol in the Management of Neuroleptic Malignant Syndrome in the University of Port Harcourt Teaching Hospital (UPTH)
Clinical Neurology and Neuroscience
Volume 1, Issue 3, August 2017, Pages: 52-55
Received: Mar. 6, 2017;
Accepted: Mar. 28, 2017;
Published: May 20, 2017
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Stanley Catherine Nonyelum, Department of Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Port Harcourt, Nigeria
Stanley Princewill Chuwuemeka, Department of Neuropsychiatry/Mental Health, College of Health Sciences, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Nkporbu Aborlo Kennedy, Department of Neuropsychiatry/Mental Health, College of Health Sciences, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Osemwegie Nosakhare, Department of Internal Medicine, College of Health Sciences, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Ugbomah Lucy Obiebi, Department of Neuropsychiatry/Mental Health, College of Health Sciences, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Neuroleptic Malignant Syndrome (NMS) is a life-threatening neurologic emergency associated commonly with the use of neuroleptic agents. In view of the high rate of fatality associated with it, urgent careful and adequate management is often required. To highlight the UPTH adopted protocol for the management of Neuroleptic Malignant Syndrome. All the cases of Neuroleptic Malignant Syndrome managed between Jan, 2008–Dec, 2014 in the unit were retrieved and our adopted management protocol critically reviewed. The outcome of our locally adopted management approach of NMS has been largely successful with 100% success rate in all 7 cases managed in the last three (3) years. All our patients recovered without any neurologic sequelae and were scheduled for adequate follow – up after discharge.
Stanley Catherine Nonyelum,
Stanley Princewill Chuwuemeka,
Nkporbu Aborlo Kennedy,
Ugbomah Lucy Obiebi,
Adopting a Local Protocol in the Management of Neuroleptic Malignant Syndrome in the University of Port Harcourt Teaching Hospital (UPTH), Clinical Neurology and Neuroscience.
Vol. 1, No. 3,
2017, pp. 52-55.
Di Venanzio, C., Marini, C., Santini, I., De Lauretis, I., and Rossi, A, (2015). Severe long term chronic complications of neuroleptic malignant syndrome: a case report. Journal of Psychopathology; 21:97-100.
Seitz DP, Gill SS. Neuroleptic Malignant Syndrome complicating antipsychotic treatment of delirium or agitation in medical and surgical patients: case reports and a review of the literature. Psychosomatics 2009; 50:8.
Shalev A. Hermesh H, Munitz H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry 1989; 50:18.
Chandrasekaran, P. K. and Grewal, G. S. (2015). An Approach to Diagnosing and Managing Neuroleptic Malignant Syndrome, Atypical Neuroleptic Malignant Syndrome and Serotonin Syndrome using a Flowchart Algorithm. Austin J Pharmacol Ther,; 3(2), 01-05.
Jae Meen Lee, et al. Malignant Neuroleptic Syndrome following Deep Brain Stimulation (2016). Malignant Neuroleptic Syndrome following Deep Brain Stimulation Surgery of Globus Pallidus Pars Internus in Cerebral Palsy. Korean J Crit Care Med, 31(1):34-38 / http://dx.doi.org/10.4266/kjccm.2016.31.1.34
Caroff SN, Mann SC. Neuroleptic Malignant Syndrome. Med Clin North Am 1993; 77:185.
Caroff SN, Rosengerg H, Fletcher JE, et al. Malignant hyperthermia susceptibility in neuroleptic malignant syndrome. Anaesthesiology 1987; 67:20.
Bonder RA, Lynch T, Lewis, Kahn D. Serotonin syndrome. Neurology 1995; 45:219.
Ener RA, Meglathery SB, Van Decker WA, Gallagher RM. Serotonin syndrome and other serotonergic disorders. Pain Med 2003; 4:63.
Lejoyeux M, Fineyre F, Ades J. The serotonin syndrome. Am J psychiatry 1992; 149:1410.
Sternbach H. The serotonin syndrome. Am J Psychiatary 1991; 148:705.
Fleischhacker WW, Unterweger B, Kane JM, Hinterhuber H. The neuroleptic malignant syndrome and its differentiation from lethal catatonia. Actapsychiatr Scand 1990; 81:3.
Castillo E, Rubin RT, Holsboer-Trachsler E. Clinical differentiation between lethal catatonia and neuroleptic malignant syndrome. Am J. Psychiatry 1989; 146:324.
Silva RR, Munoz DM, Alpert M, et al. Neuroleptic Malignant Syndrome in children and adolescents. J amAcad Child Adolesc Psychiatry. The myth of elevated serum creatinine phosphokinase level and neuroleptic malignant syndrome. Br. J. Psychiatry 1991; 158:706.
Hermesh H, Manor I, Shiloh R, et al. High serum creatinine kinase level: possible risk factor for neuroleptic malignant syndrome. J ClinPsychopharmacol 2002; 22:252.
Elser AR, Neff MS, Slifkin RF. Acute myoglobinuric renal failure. A consequence of the neuroleptic malignant syndrome. Arch Intern Med 1982; 142:601.
Lee JW. Serum iron in catatonia and neuroleptic malignant syndrome. Biol Psychiatry 1998; 44:499.
Blasi C, DÁmore F, Levati M, Bandinelli MC. (Neuroleptic malignant syndrome: a neurologic pathology of great interest for the internist). Ann Ital Med Int 1998; 13:111.
Parry Ak, Ormerod LP, Hamlin GW, Saleem PT. Recurrent sinus arrest in association with neuroleptic malignant syndrome. Br J. Psychiatry 1994; 164:689.
Lappa A, Podesta M, Capelli O, et al. Successful treatment of a complicated case of neuroleptic malignant syndrome. Intensive care med 2002; 28:976.
Gregorakos L, Thomaides T, Stratouli S, Sakayanni E. The use of clonidine in the management of autonomic overactivity in neuroleptic malignant syndrome. ClinAuton Res 2000; 10:193.
Bleu MG, Schneider SM, Noro S, Fraley DS. Successful treatment of neuroleptic malignant syndrome with sodium nitroprusside. Ann Intern Med 1986; 104:56.
Bond WS. Detection and management of the neuroleptic malignant syndrome. Clin Pharm 1984; 3:302.
Wang HC, Hsieh Y. Treatment of neuroleptic malignant syndrome with subcutaneous apomorphinemonotherapy. MovDisord 2001; 16:765.
Thomas P, Maron M, Rascle C, et al. Carbamazepine in the treatment of neuroleptic malignant syndrome. Boil Psychiatry 1998; 43:303.
Rosenberg MR,, Green M. Neuroleptic malignant syndrome. Review of response to therapy. Arch Intern Med 1989; 149:1927.
Sakkas P, Davis JM, Janicak PG, Wang ZY. Drug treatment of the neuroleptic malignant syndrome. Psychopharmacol bull 1991; 27:381.
Rosebruch PI, Stewart T, Mazurek MF. The treatment of neuroleptic malignant syndrome. Are dantrolene and bromocriptine useful adjuncts to supportive care? Br J Psychiatry 1991; 159:709.
Davis JM, Janicak PG, Sakkas P, et al. Electroconvulsive therapy in the treatment of the Neuroleptic Malignant Syndrome. ConvulsPsycgiatry 1999; 33:650.
Guze BH, Baxter LR. Current concepts: Neuroleptic Malignant Syndrome; New England Journal of Medicine. 1985; 313 (3):163-166.
Boluyt N, Bollen CW, Bos AP, Kok JH, Offringa M. Fluid resuscitation in renal and paediatric hypovolemic shock. A Dutchpaediatric society evidence based clinical practice guideline. Intensive care medicine. 2006; 32 (7):995-1003.
World Health Organization. The treatment of Diarrhea, a manual for physicians and other senior health workers. Treatment plan for severe dehydration: pp 8-16.
Caroff SN, Mann SC, Keck PE Jr, Francis A. Residual catatonic state following neuroleptic malignant syndrome. J ClinPsychopharmacol 2000; 20:257.
Susman VL, Addonizo G. Recurrence of neuroleptic malignant syndrome. J NervMent Dis 1988; 176:234.
Valamoor VR. Neuroleptic Malignant Syndrome. Recognition, prevention and management. Drug saf 1998 \; 19:73.
Chandran GJ, Mikler JR, Keegan DL. Neuroleptic Malignant Syndrome: a case report and discussion. CMAJ 2003; 169:439.
Strawn JR, Keck PE Jr, Caroff SN. Neuroleptic Malignant Syndrome. Am J Psychiatry 2007; 164:870.