Atypical neuroleptic malignant syndrome caused by olanzapine.

OBJECTIVE

Neuroleptic malignant syndrome (NMS) is a rare syndrome with four main symptoms: rigidity, hyperthermia, altered mental status and autonomic instability. We report a patient with an atypical manifestation of NMS.

METHOD

A single case was reported.

RESULTS

A patient with pneumonia developed delirium and was treated with olanzapine and developed a NMS with fluctuating hyperthermia and autonomic instability during a month. Only slight rigidity was present. Creatine kinase was not elevated. The patient was severely agitated and manic. After discontinuation of olanzapine the patient showed no psychopathology or hyperthermia.

CONCLUSION

NMS should be considered when patients treated with antipsychotics develop one or more symptoms of NMS.