Neera Ghaziuddin1, Melissa Hendriks2, Paresh Patel1, Lee E Wachtel3, Dirk M Dhossche4. 1. 1 Department of Psychiatry, University of Michigan , Ann Arbor, Michigan. 2. 2 Henry Ford Health System , Detroit, Michigan. 3. 3 Kennedy Kreiger Institute, Baltimore, Maryland. 4. 4 Department of Psychiatry, University of Mississippi Medical Center , Jackson, Mississippi.
Abstract
OBJECTIVE: To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents. BACKGROUND: NMS and MC are life-threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent. Some authorities believe that apart from the history of exposure to an AP medication, the two conditions are identical. The symptoms of NMS/MC include severe agitation, behavior disregulation, motor and speech changes, self-injury and aggression, autonomic instability, and a range of psychiatric symptoms (affective, anxiety, or psychotic symptoms). Patients may be misdiagnosed with another disorder leading to extensive tests and a delay in treatment. Untreated, the condition may be fatal in 10%-20% of patients, with death sometimes occurring within days of disease onset. METHOD: We describe the presentation and management of five children and adolescents with NMS/MC. CONCLUSION: MC and NMS are life-threatening medical emergencies, which if diagnosed promptly, can be successfully treated with known effective treatments (benzodiazepines and/or electroconvulsive therapy).
OBJECTIVE: To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents. BACKGROUND:NMS and MC are life-threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent. Some authorities believe that apart from the history of exposure to an AP medication, the two conditions are identical. The symptoms of NMS/MC include severe agitation, behavior disregulation, motor and speech changes, self-injury and aggression, autonomic instability, and a range of psychiatric symptoms (affective, anxiety, or psychotic symptoms). Patients may be misdiagnosed with another disorder leading to extensive tests and a delay in treatment. Untreated, the condition may be fatal in 10%-20% of patients, with death sometimes occurring within days of disease onset. METHOD: We describe the presentation and management of five children and adolescents with NMS/MC. CONCLUSION: MC and NMS are life-threatening medical emergencies, which if diagnosed promptly, can be successfully treated with known effective treatments (benzodiazepines and/or electroconvulsive therapy).
Authors: Daniel Felipe Ariza-Salamanca; María Gabriela Corrales-Hernández; María José Pachón-Londoño; Isabella Hernández-Duarte Journal: Front Mol Neurosci Date: 2022-09-29 Impact factor: 6.261