Neuroleptic Malignant Syndrome (NMS)

Question 1

FALTER

Answer 1

F = Fever
A = Autonomic instability
L = Leukocytosis + Lead Pipe Rigidity
T = Tremor
E = Elevated CK
R = Rigid muscles

Question 2

Onset

Answer 2

months to years of antipsychotic treatment. can ONLY develop in association with the use of neuroleptic medication or if the patient has been withdrawn from a dopaminergic drug

Question 3

Presentation

Answer 3

Hyperthermia, EPS effects, autonomic effects (labile), CNS effects

Question 4

CNS effects

Answer 4

• Drowsiness
• Confusion
• Coma
• Mutism
• Incontinence

Question 5

EPS effects

Answer 5

• Rigidity
• Bradykinesia or akinesia
• Abnormal movement and postures
• Dysphagia
• Tremor

Question 6

Treatment (pharmaco)

Answer 6

Dantrolene (muscle relaxant) or bromocriptine (dopamine agonist)

Question 7

Investigations

Answer 7

raised CK, leuckocytosis, elevated transaminases - all to a greater degree than in serotonin syndrome