Neuroleptic Malignant Syndrome-an uncommon complication of a common drug- a case report

Neuroleptic Malignant Syndrome (NMS) is a life-threatening idiosyncratic reaction to neuroleptics and rarely to antidopaminergics. Although the incidence in India is 0.14%, it is potentially a fatal complication. NMS occurs due to a blockade in the dopamine receptor and nigrostriatal pathway. The following report is about our patient who was diagnosed with NMS. This patient was diagnosed of NMS due to a progressive rise in CPK NAC and liver enzymes, metabolic acidosis and pyrexia of unknown origin not responding to treatment. No foci for the cause of pyrexia were ascertained. However, a positive drug history of recent administration of Inj. Metaclopramide was the present treatment in the form of supportive care, by controlling rigidity, hyperthermia and preventing complications that can occur following the affliction of this condition. NMS is a potentially reversible fatal complication with a mortality rate of 30%. Indiscriminate usage of neuroleptics and antidopaminergics can inadvertently lead to patients developing this condition. This case has been reported to create awareness amongst physicians about this complication.