Neuroleptic malignant syndrome: recognizing an unrecognized killer.

NMS has been with us for years as an often unrecognized entity. Nurses ask why there are "more of these cases" when what might be happening is that NMS is being discovered for what it is. There have been cases where the authors are convinced that the "pneumonia" or "urinary tract infection" was in fact a mild case of NMS that cleared. Probably some of the "sudden deaths" that have been reported in the past with neuroleptics are the results of undiagnosed NMS. Any patient with a fever, fluctuating vital signs, and signs of difficulty with moving should be considered as a possible case of NMS. All nurses and physicians need to be aware of the possibility, but those who work with psychiatric patients must not forget this potentially life-threatening problem.