Mesejo A, Núñez C, Simó M, Blanquer J, Pérez P L, Ruiz F, Cuñat J
Servicio de Medicina Intensiva, Hospital Clínico Universitario, Valencia.
Rev Neurol. 1995 Jan-Feb;23(119):136-8.
The Malignant Neuroleptic Syndrome (MNS) is characterised by the acute appearance of hyperthermia, muscular rigidity, loss of motor control, and alterations in the level of consciousness, which could prove fatal if not rapidly diagnosed and treated. It is held to be a serious idiosyncratic reaction which appears in patients being treated with neuroleptics, independently of the dosage and the length of time the drug has been prescribed. Relapses do not usually occur when the drug is re-prescribed, once the acute phase has been passed, which suggests the existence of predisposing factors. There are frequent complications (acute respiration difficulties, acute kidney failure, disseminated intravascular coagulation and multiorganic failure) which condition the prognosis. The treatment consists of the suppression of the neuroleptic, rehydration, and specific drugs (bromocryptine, sodium dantroline). We have analysed two new cases which reacted badly, one of them with a multiorganic failure and the other, who had a good initial therapeutical response but who went on to develop a peripheral neuropathy, an infrequent complication in international medical casebooks.
恶性抗精神病药物综合征（MNS）的特征是急性出现高热、肌肉僵硬、运动控制丧失和意识水平改变，如果不迅速诊断和治疗可能会致命。它被认为是一种严重的特异质性反应，出现在使用抗精神病药物治疗的患者中，与药物剂量和用药时间长短无关。一旦急性期过去，再次使用该药物时通常不会复发，这表明存在易感因素。常伴有并发症（急性呼吸窘迫、急性肾衰竭、弥散性血管内凝血和多器官功能衰竭），这些并发症决定了预后。治疗包括停用抗精神病药物、补液和使用特定药物（溴隐亭、丹曲林钠）。我们分析了两例反应不佳的新病例，其中一例发生了多器官功能衰竭，另一例最初治疗反应良好，但随后发展为周围神经病变，这在国际医学病例中是一种罕见的并发症。
