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- Title
Refractory and Complicated Neuroleptic Malignant Syndrome Cured by ECT and Followed by Brain Atrophy: Case Report.
- Authors
Chia-sheng Chen; Jen-Lin Chang; Ting-Sheng Chung; Chi-Hung Lin; Shang-Lun Lin; Dong-Sheng Tzeng; Jung-Wu Yang
- Abstract
Introduction: Neuroleptic malignant syndrome (NMS) is an idiosyncratic and rare but serious adverse effect that has been reported with the use of all antipsychotics. The mortality rate may be as high as 50% if failure of one organ is present. Presentation of case: Herein, we report a rare case of paliperidone-induced 92-day NMS in a 60-year-old female with silent lacunar infarctions at the lentiform nucleuses. The patient suffered from episodes of nosocomial pneumonia and urosepsis. Then, her chronic subclinical hyperthyroidism transformed to a thyroid storm. Her dependence on nasogastric and foley tubes was refractory to hydration, carbimazole, antibiotics, and the combined antiparkinsonian therapy of high-dose bromocriptine and amatadine. After 6 sessions of electroconvulsive therapy (ECT), the patient returned to normal consciousness, mobility of the 4 limbs, and normal speech function. Discussion: This case serves as a reminder that it is never too late to use ECT to resolve NMS, in spite of a complicated and prolonged medical illness, and that NMS may incur brain atrophy as a sequela. Conclusion: The whole course of complicated NMS warranted further careful attention.
- Subjects
BRAIN anatomy; NEUROLEPTIC malignant syndrome; ANTIPSYCHOTIC agents; DRUG side effects; ELECTROCONVULSIVE therapy; ATROPHY; DIAGNOSIS
- Publication
International Medical Journal, 2016, Vol 23, Issue 6, p712
- ISSN
1341-2051
- Publication type
Article