Neuroleptic malignant syndrome NMS

• Facts:
  Drug induced, idiosyncratic reaction (MC is haloperidol)
  Symptoms usually begin within 2 weeks of drug initiation
  Mortality rates range from 10-20%
• History / PE:
  Fever, altered mental status
  Muscle rigidity ("lead pipe extremities")
  Autonomic instability
  Diaphoresis
• Diagnosis:
  Elevated serum CK (muscle necrosis)
  Leukocytosis
  Electrolyte abnormalities
• Treatment:
  Dantrolene
  Immediate cessation of offending agent
  Bromocriptine
  Amantadine
• Associated With:
  Typical antipsychotics (especially Haldol)