Lotstra F, Linkowski P, Mendlewicz J
Biol Psychiatry. 1983 Feb;18(2):243-7.
The neuroleptic malignant syndrome (NMS) is an uncommon and potentially lethal complication of therapy with neuroleptics characterized by pallor, hyperthermia, and extrapyramidal signs (Delay and Deniker, 1968). Malignant hyperthermia (MH) is a rare but often fatal complication of general anesthesia characterized by hyperpyrexia and muscle rigidity, but not related to neuroleptic therapy. For both syndromes, NMS and MH, a common pathophysiology has been considered (Meltzer, 1973; Itoh, 1977; Caroff, 1980). These two syndromes may also be clinically indistinguishable from "acute lethal catatonia" characterized by fever, muscular hypertonicity, and stupor, first described by Stauder in 1934. We now report a case in whom NMS appeared following neuroleptic treatment for a psychotic depressive syndrome. After remission from the NMS, the patient underwent general anesthesia nine times for electroconvulsive therapy (ECT) without ill effect. This case supports the theory of distinct pathogenic mechanisms for both NMS and MH.
抗精神病药恶性综合征（NMS）是一种使用抗精神病药物治疗时罕见但可能致命的并发症，其特征为面色苍白、高热及锥体外系症状（德莱和德尼凯，1968年）。恶性高热（MH）是全身麻醉时一种罕见但常致命的并发症，特征为高热和肌肉强直，但与抗精神病药物治疗无关。对于NMS和MH这两种综合征，人们认为存在共同的病理生理学机制（梅尔策，1973年；伊藤，1977年；卡罗夫，1980年）。这两种综合征在临床上也可能与1934年施陶德首次描述的以发热、肌肉张力亢进和木僵为特征的“急性致死性紧张症”难以区分。我们现在报告一例在接受抗精神病药物治疗精神性抑郁综合征后出现NMS的病例。NMS缓解后，该患者接受了9次全身麻醉下的电休克治疗（ECT），未出现不良影响。该病例支持NMS和MH具有不同致病机制的理论。
