  |
|
 |
|
Case Report
| ||||||
| Neuroleptic malignant syndrome in severe vascular dementia: Diagnostic challenge due to baseline impaired mental status | ||||||
| Thein Swe1, Akari Thein Naing2 | ||||||
|
1Medical Doctor, Internal Medicine, Interfaith Medical Center, Brooklyn, USA.
2Medical Doctor, Internal Medicine, Brooklyn, USA. | ||||||
| ||||||
|
[HTML Full Text]
[PDF Full Text]
[Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar] 
|
| How to cite this article |
| Swe T, Naing AT. Neuroleptic malignant syndrome in severe vascular dementia: Diagnostic challenge due to baseline impaired mental status. Int J Case Rep Imag 2016;7(4):208–211. |
|
Abstract
|
|
Introduction:
Neuroleptic malignant syndrome (NMS) is a life-threatening disease more often considered than truly diagnosed. The NMS is a life-threatening neurologic emergency associated with the use of antipsychotic drugs and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia.
Case Report: A 69-year-old wheel chair bound male with past medical history of severe vascular dementia with behavioral problems, schizoaffective disorder referred from nursing home due to fever for 1 day. According to his room-mate, his baseline mental status use to be drowsy and disoriented. Vitals showed temperature 102°F (38.8°C), tachycardia, high blood pressure 140/90 mmHg, tachypnea and low oxygen saturation of 87% on room air. Arterial blood gases showed hypoxia and respiratory alkalosis with high A-a gradient. Also suspected infection due to leukocytosis with neutrophilia. However, we kept neuroleptic malignant syndrome (NMS) in mind since patient was taking haloperidol for episodic agitation although haloperidol dose was unchanged and no new drugs were added. When total creatine kinase came back as 3142 IU/L, he was managed successfully with dantrolene and amantadine. Conclusion: Neuroleptic malignant syndrome can be difficult to diagnose in the presence of baseline altered mental status. It is important to have early diagnosis of NMS in patients who presented with altered mental status and muscle rigidity with underlying dementia and psychiatric illness. | |
|
Keywords:
Altered mental status, Dantrolene, Amantadine, Dementia, Neuroleptic malignant syndrome
| |
|
[HTML Full Text]
[PDF Full Text]
|
|
Author Contributions
Thein Swe – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Akari Thein Naing – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
|
Guarantor of submission
The corresponding author is the guarantor of submission. |
|
Source of support
None |
|
Conflict of interest
Authors declare no conflict of interest. |
|
Copyright
© 2016 Thein Swe et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
|
|