Neuroleptic Malignant Syndrome Flashcards
1
Q
What is classic symptoms of NMS?
A
MACH
Muscular rigidity - lead pipe or cogwheeling
Autonomic instability
Changes in level of conscious state
Hyperthermia
2
Q
Which drugs can trigger NMS?
A
Atypical antipsychotics eg Olanzapine Risperidone Paliperidone Aripiprazole Quetiapine
Clozapine less so
3
Q
What is the approach to treatment?
A
Supportive therapy
Trial dantrolene (muscle relaxant), amantadine, bromocriptine (dopamine agonist)
ICU transfer
4
Q
What is the pathophysiology of NMS?
A
Over blockade of dopaminergic receptors
5
Q
How do you differentiate NMS from serotonin syndrome?
A
History: Which agents they’ve taken
Examination: NMS has hyporeflexia and cogwheeling/lead pipe rigidity whereas SS has hyperreflexia and clonus
