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[一例因停用精神药物引发的抗精神病药恶性综合征]

[A case of neuroleptic malignant syndrome caused by discontinuation of psychotropic drugs].

作者信息

Takahashi Yoshiya, Yaguchi Masamitsu, Yaguchi Hisa, Togashi Atsuhito, Suzuki Mitsunori

机构信息

Department of Internal Medicine, Shiseido General Hospital.

Department of Neurology, Shiseido General Hospital.

出版信息

Rinsho Shinkeigaku. 2022 Nov 26;62(11):850-855. doi: 10.5692/clinicalneurol.cn-001764. Epub 2022 Oct 26.

Abstract

A 71-year-old woman with schizophrenia and diabetes discontinued psychotropic drugs due to right purulent knee bursitis. Five days after discontinuation, she presented with a fever of >40°C, severe disturbance of consciousness, lead-pipe muscle rigidity, tachypnea, and hypertension. She was diagnosed with neuroleptic malignant syndrome (NMS) induced by the discontinuation of psychotropic drugs. The patient's symptoms improved after dantrolene administration and systemic management. We investigated the clinical characteristics of cases with NMS induced by the discontinuation of psychotropic drugs reported in Japan, including the present case. When psychotropic drugs are discontinued, patients should be monitored for signs of NMS. Strict management of early onset NMS is needed to prevent the condition from worsening.

摘要

一名患有精神分裂症和糖尿病的71岁女性因右膝脓性滑囊炎停用了精神药物。停药五天后,她出现体温超过40°C、严重意识障碍、铅管样肌强直、呼吸急促和高血压。她被诊断为因停用精神药物诱发的抗精神病药恶性综合征(NMS)。给予丹曲林并进行全身治疗后,患者症状有所改善。我们调查了包括本病例在内的日本报道的因停用精神药物诱发NMS病例的临床特征。停用精神药物时,应监测患者是否出现NMS迹象。需要对早期发作的NMS进行严格管理,以防止病情恶化。

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