Amore M, Montanari M
Istituto di Psichiatria P. Ottonello, Università degli Studi di Bologna.
Minerva Psichiatr. 1992 Oct-Dec;33(4):259-83.
Neuroleptic malignant syndrome is characterised by muscular rigidity, fever and signs of severe vegetative nervous system involvement. Its etiopathogenesis is still unclear and the disease is potentially fatal. Its clinical aspects, which are often only partially manifested, make it difficult to formulate a correct diagnosis in time, not least due to the problem of differential diagnosis with other syndromes with similar symptoms but a different pathogenesis, psychopathology and therapy: acute lethal catatonia, fatal acute delirium, heat-stroke, malignant hyperthermia. The speed of the diagnosis is vital for effective therapy, but this is made even more difficult by the need approach. The paper presents eleven case studies; after an analysis of the numerous clinical aspects of the syndrome and the definition of its diagnostic parameters, an appropriate therapeutic protocol is outlined. Lastly, the problem of retreatment using a neuroleptic of the same or a different class is discussed once the acute phase has been overcome.
神经阻滞剂恶性综合征的特征为肌肉强直、发热以及严重的自主神经系统受累迹象。其病因病机仍不明确,且该疾病有潜在致命风险。其临床症状往往仅部分表现出来,这使得及时做出正确诊断变得困难,尤其是因为要与其他具有相似症状但发病机制、精神病理学及治疗方法不同的综合征进行鉴别诊断,这些综合征包括:急性致死性紧张症、致命性急性谵妄、中暑、恶性高热。诊断的速度对于有效治疗至关重要,但由于需要采取的方法,这一过程变得更加困难。本文介绍了11个病例研究;在分析了该综合征的众多临床症状并确定其诊断参数后,概述了一种适当的治疗方案。最后,讨论了在急性期过后使用同一类或不同类神经阻滞剂进行再治疗的问题。