Neuroleptic Malignant Syndrome Presenting with Self Injurious Behaviour OD04-OD06
No. 1023, Prestige Misty Waters, Kempapura, Hebbal, Bangalore-560024, Karnataka, India.
Neuroleptic Malignant Syndrome (NMS) is an emergency condition produced as an ill effect of certain drugs. Tetrad of symptoms includes fever, muscle rigidity, autonomic features and altered mental status. Pathophysiology underlying this condition is dopamine receptor blockade or depletion of dopamine. Author presented a case of 45-year-old female, alcoholic with symptoms of self-mutilating behaviour such as finger biting and tongue bites, elevated Creatine Phosphokinase (CPK) levels and no signs of autonomic dysfunction. Differential diagnosis included was malignant hyperthermia, neuroleptic malignant syndrome, serotonin syndrome, lethal catatonia, meningitis/encephalitis, heat stroke and anticholinergic toxicity. Final diagnosis of neuroleptic malignant syndrome was made according to Caroff SN and Mann SC criteria. She was treated with bromocriptine with an improvement in her condition. Clear workup including identification of other systemic and neuropsychiatric conditions with overlapping symptoms is important for accurate diagnosis of this condition.