Reilly J J, Crowe S F, Lloyd J H
Neuropsychiatric Centre, Rosanna, Victoria.
Aust N Z J Psychiatry. 1991 Dec;25(4):499-505. doi: 10.3109/00048679109064443.
The neuroleptic malignant syndrome (NMS) has undergone a number of changes since it was first described in the 1960s. This paper presents a review of these changes from the traditional approach of rigid categorization through the more flexible operational definitions to a spectrum of neuroleptic toxicity. This spectrum spans neuroleptic-induced extrapyramidal side effects, possible stages of neuroleptic toxicity, and the full blown neuroleptic malignant syndrome. Different theoretical concepts of the syndrome have contributed to diagnostic confusion among clinicians and thus to difficulties in management. The concept of a spectrum of neuroleptic toxicity provides a coherent theoretical base for understanding NMS and thus allows for more rapid identification of the potential threat of NMS. Three cases are presented and discussed to highlight the utility of the concept of a clinical spectrum.
自20世纪60年代首次被描述以来，抗精神病药物恶性综合征（NMS）已经历了诸多变化。本文回顾了这些变化，从传统的严格分类方法到更灵活的操作性定义，再到抗精神病药物毒性谱。这个谱涵盖了抗精神病药物引起的锥体外系副作用、抗精神病药物毒性的可能阶段以及全面发作的抗精神病药物恶性综合征。该综合征的不同理论概念导致了临床医生之间的诊断混乱，进而造成管理困难。抗精神病药物毒性谱的概念为理解NMS提供了一个连贯的理论基础，从而能够更快速地识别NMS的潜在威胁。本文展示并讨论了三个病例，以突出临床谱概念的实用性。
