Thapliyal Khyati, Garg Ashutosh, Singh Vivek P
Department of Internal Medicine, BLK-Max Super Speciality Hospital, New Delhi, India.
J Family Med Prim Care. 2022 Nov;11(11):7430-7433. doi: 10.4103/jfmpc.jfmpc_724_22. Epub 2022 Dec 16.
Fever is a common symptom encountered in clinical practice. Hyperthermia, though infrequently encountered, can be genetical (malignant hyperthermia) or acquired when the body temperature rises beyond a certain set point that is controlled by the hypothalamus. We report a case of an elderly male who reported to us with hyperthermia, accelerated hypertension, and brain haemorrhage (as a sequelae of uncontrolled hypertension). A thorough clinical history pointed towards neuroleptic malignant syndrome (NMS). A remarkable response was observed with dantrolene and bromocriptine along with the discontinuation of the offending drug. With conservative management, the patient had complete recovery. This case highlights the importance of even sub-therapeutic drug dosage, particularly neuropsychiatric drugs, in the development of neurological catastrophe.
发热是临床实践中常见的症状。体温过高虽然不常见，但可能是遗传性的（恶性高热），也可能是后天获得性的，即体温升高超过下丘脑控制的某个设定点。我们报告一例老年男性病例，该患者因体温过高、高血压急症和脑出血（为未控制的高血压后遗症）前来就诊。详细的临床病史指向神经阻滞剂恶性综合征（NMS）。使用丹曲林和溴隐亭并停用致病药物后观察到显著疗效。经过保守治疗，患者完全康复。该病例强调了即使是亚治疗剂量的药物，尤其是神经精神药物，在引发神经灾难方面的重要性。
