Nagel M, Freisberg S, Junghanns K, Moll C K E, Willenborg B
Psychiatrie, Universität Lübeck.
Psychiatrie, Asklepios Klinik, Hamburg.
Fortschr Neurol Psychiatr. 2015 Jul;83(7):373-80. doi: 10.1055/s-0035-1553246. Epub 2015 Jul 22.
Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening medication-induced syndrome. Core symptoms are hyperthermia, diaphoresis, rigidity, impaired consciousness, and creatinine kinase elevation. Additionally, patients show vegetative dysregulation including blood pressure fluctuations. The purpose of this paper is to summarize current findings, to facilitate diagnostics and to distinguish NMS from other syndromes.
We performed a systematic review of the literature. We included scientific publications, books and guidelines.
In this review we summarize the current diagnostic criteria, differential diagnosis, pathogenesis and therapeutic options.
Clinical symptoms of NMS are heterogeneous and it is difficult to diagnose early states. Early interventions are important to ensure fast and complete recovery. Since NMS is a rare condition, publications on NMS-therapy are based on single-case reports, meta-analysis or expert opinions. Core symptoms should be considered: Exposure to dopamine-antagonists, hyperthermia, diaphoresis, rigidity, mental status alteration, creatinine kinase elevation, and vegetative dysregulation.
抗精神病药恶性综合征（NMS）是一种罕见但可能危及生命的药物诱导综合征。核心症状为高热、多汗、强直、意识障碍及肌酸激酶升高。此外，患者还表现出植物神经功能失调，包括血压波动。本文旨在总结当前研究结果，以促进诊断并将NMS与其他综合征相鉴别。
我们对文献进行了系统综述。纳入的文献包括科学出版物、书籍及指南。
在本综述中，我们总结了当前的诊断标准、鉴别诊断、发病机制及治疗选择。
NMS的临床症状具有异质性，早期状态难以诊断。早期干预对于确保快速、完全康复很重要。由于NMS是一种罕见疾病，关于NMS治疗的出版物基于单病例报告、荟萃分析或专家意见。应考虑核心症状：接触多巴胺拮抗剂、高热、多汗、强直、精神状态改变、肌酸激酶升高及植物神经功能失调。
