Arslankoylu Ali Ertug, Kutuk Meryem Ozlem, Okuyaz Cetin, Toros Fevziye
Mersin University Faculty of Medicine, Department of Pediatrics, Pediatric Intensive Care Unit, Mersin, Turkey.
Pediatr Rep. 2011 Jun 30;3(3):e19. doi: 10.4081/pr.2011.e19. Epub 2011 Jun 24.
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal disease characterized by fever, muscle rigidity, delirium and autonomic instability. Here we report a child, with NMS due to the risperidone misdiagnosed as status epilepticus. Nine year old boy, who had been under high dose risperidone treatment for 8 weeks, admitted to the emergency room because of the contractions (evaluated as status epilepticus) persisting for 7 hours. Since there was neuroleptic treatment in the past medical history and, unconsciousness, muscular rigidity, diaphoresis, hypertermi and, hypotension in physical examination, leucocytosis and elevated creatininphosphokinase levels in laboratory tests, the patient was evaluated as NMS and discharged without any complications. We reported this case to point out that; NMS may be misdiagnosed as status epilepticus in children when EEG monitoring is unavailable. When a child admitted to the emergency room because of suspicious convulsion neuroleptic drug use must surely be asked.
抗精神病药恶性综合征（NMS）是一种罕见但可能致命的疾病，其特征为发热、肌肉强直、谵妄和自主神经功能不稳定。在此，我们报告一名因利培酮导致NMS的儿童，该患儿被误诊为癫痫持续状态。一名9岁男孩，接受高剂量利培酮治疗8周，因持续7小时的抽搐（被评估为癫痫持续状态）而入住急诊室。由于既往病史中有抗精神病药物治疗史，且体格检查发现意识不清、肌肉强直、多汗、高热及低血压，实验室检查发现白细胞增多和肌酐磷酸激酶水平升高，该患者被诊断为NMS，出院时无任何并发症。我们报告此病例以指出：在无法进行脑电图监测时，儿童NMS可能被误诊为癫痫持续状态。当儿童因可疑惊厥入住急诊室时，必须询问是否使用过抗精神病药物。
