Simon Leslie V., Hashmi Muhammad F., Callahan Avery L.
Mayo Clinic Florida
National Health Service
Neuroleptic malignant syndrome (NMS) is a life-threatening syndrome associated with the use of dopamine-receptor antagonist medications or with the rapid withdrawal of dopaminergic medications. NMS has been associated with virtually every neuroleptic agent but is more commonly reported with the typical antipsychotics like haloperidol and fluphenazine. Classic clinical characteristics include mental status changes, fever, muscle rigidity, and autonomic instability. While uncommon, NMS remains an important part of the differential diagnosis of fever and mental status changes because it requires early diagnosis and treatment to prevent significant mortality and death. Treatment involves immediately discontinuing the offending agent, aggressive supportive care to manage and prevent complications, and pharmacologic therapy in severe cases. The empiric medications most frequently used for refractory NMS include bromocriptine mesylate, a dopamine agonist, and dantrolene sodium, a muscle relaxant. If the syndrome is due to the rapid withdrawal of dopaminergic medication, rapid re-institution of the medication may improve symptoms.[2][3]
抗精神病药恶性综合征（NMS）是一种危及生命的综合征，与使用多巴胺受体拮抗剂药物或多巴胺能药物的快速撤药有关。NMS几乎与每一种抗精神病药物都有关联，但更常见于典型抗精神病药物，如氟哌啶醇和氟奋乃静。经典的临床特征包括精神状态改变、发热、肌肉强直和自主神经功能不稳定。虽然不常见，但NMS仍然是发热和精神状态改变鉴别诊断的重要组成部分，因为它需要早期诊断和治疗以预防显著的死亡率和死亡。治疗包括立即停用致病药物、积极的支持性护理以管理和预防并发症，以及在严重病例中进行药物治疗。最常用于难治性NMS的经验性药物包括多巴胺激动剂甲磺酸溴隐亭和肌肉松弛剂丹曲林钠。如果综合征是由于多巴胺能药物的快速撤药所致，快速重新使用该药物可能会改善症状。[2][3]
