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Neuroleptic malignant syndrome is a rare neurological disorder that occurs due to the side effects of neurological agents such as sedatives, hypnotics, anti-depressant drugs and anti-psychotic drugs. These agents alter the brain functions and the response to certain brain impulses, thus causing altered neurological action.
Neuroleptic malignant syndrome is usually characterised by high fever, muscle stiffness and altered mental status. It may also prove to be life-threatening when this condition is not diagnosed or treated at an early stage.
A major number of neuroleptic malignant syndrome cases are reported in the first week of use of neuroleptic agents with a higher number of cases reported in men when compared to women population.
The symptoms of neuroleptic malignant syndrome include:
In severe conditions neuroleptic malignant syndrome may also produce symptoms such as:
Neuroleptic malignant syndrome occurs due to the change in the neurotransmitter levels in the brain majorly due to dopamine D2 receptor antagonism. The dopamine D2 receptor is found in abundance in the central nervous system that helps in the effective cell to cell communication.
A decrease in the dopamine levels in the brain causes increased muscle rigidity and also increases the body temperature and alters mood swings when they come in contact with the hypothalamus.
Certain studies also prove neuroleptic malignant syndrome to occur due to a genetic related disorder called malignant hyperthermia that causes adverse reactions due to anaesthetic drugs.
The risk of developing neuroleptic malignant syndrome increases with the following factors:
The other possible risk factors include:
The possible complications that arise due to neuroleptic malignant syndrome include:
The diagnosis of neuroleptic malignant syndrome is based on the physical finding, previous family history, laboratory parameters and image scans.
The physical findings help in determining the cause of neuroleptic malignant syndrome causes such as muscle rigidity, high fever, cognitive impairment and other vital signs.
The initial treatment followed to treat neuroleptic malignant syndrome includes discontinuing the use of dopaminergic agonist drugs. This is followed by use of nutrient and fluid replenishment that helps in faster recovery from the condition.
The use of anti-pyretic agents and muscle relaxants are used to treat hyperthermia and muscle rigidity respectively. Other medication may also include drugs to increase the dopamine levels in the brain, antidepressant and anticonvulsive agents.
The treatment of neuroleptic malignant syndrome should include supportive care to prevent the risk of liver and kidney impairment.
Neuroleptic malignant syndrome can be managed by effective use of medications. A large group of people showed better tolerance to neuroleptic agents post-treatment. It was also effectively managed by using less potent neuroleptic agents.
Geeta Dutta, a patient from West Bengal got in touch with Dr Venugopal Subramaniam, Consultant Neurosurgeon at Manipal Hospitals Whitefield through the OPD clinic programme and then later was guided by him towards a craniotomy & brain tumour removal.
Manika Saha, a patient from West Bengal got in touch with Dr. Venugopal Subramaniam, Consultant Neurosurgeon at Manipal Hospitals Whitefield through the OPD clinic programme and then later was guided by him towards a brain tumour removal in Whitefield, Bengaluru which gave her vision back.
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