Dept. of Psychiatry, Mass. General Hospital, Boston, MA 02114, USA.
Psychosomatics. 2010 Jul-Aug;51(4):349-54. doi: 10.1176/appi.psy.51.4.349.
Neuroleptic malignant syndrome (NMS) represents an iatrogenic form of malignant catatonia, and simple catatonia has been shown to predispose to NMS.
The authors present the case of a bipolar patient with catatonic features who developed NMS after receiving haloperidol.
Supportive therapy, including rehydration, electrolyte restoration, and blood pressure aids were given, together with antipyretics, antibiotics, and anticoagulants. The patient was also started on bromocriptine and diazepam.
Supportive care, diazepam, and dopamine agonists yielded only partial benefit. However, switching from diazepam to lorazepam, in combination with electroconvulsive therapy (ECT) and a long-acting dopamine agonist led to the resolution of NMS.
This case sheds further light on the relationship between catatonia and NMS. As noted in the literature, ECT in combination with lorazepam proved to be safe and effective for NMS.
神经阻滞剂恶性综合征（NMS）代表一种医源性的恶性紧张症，而单纯紧张症已被证明易导致 NMS。
作者报告了一例有紧张症特征的双相情感障碍患者，在接受氟哌啶醇治疗后发生 NMS。
给予支持性治疗，包括补液、电解质恢复和血压辅助，同时给予退热、抗生素和抗凝剂。还开始使用溴隐亭和安定。
支持性护理、安定和多巴胺激动剂仅部分有效。然而，从安定切换到劳拉西泮，联合电惊厥治疗（ECT）和长效多巴胺激动剂，导致 NMS 得到缓解。
该病例进一步阐明了紧张症和 NMS 之间的关系。正如文献中所指出的，ECT 联合劳拉西泮被证明对 NMS 是安全有效的。
