Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review

Soumaya Touzani; Mohammed Hamdouni; Nawfal Houari; Youssef Yaakoubi Khbiza; Abderrahim Elbouazzaoui; Brahim Boukatta; Nabil Kanjaa

doi:10.18700/jnc.210019

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자료유형: 학술저널

저자정보: Soumaya Touzani (Sidi Mohammed Ben Abdellah University) Mohammed Hamdouni (Sidi Mohammed Ben Abdellah University) Nawfal Houari (Sidi Mohammed Ben Abdellah University) Youssef Yaakoubi Khbiza (Sidi Mohammed Ben Abdellah University) Abderrahim Elbouazzaoui (Sidi Mohammed Ben Abdellah University) Brahim Boukatta (Sidi Mohammed Ben Abdellah University) Nabil Kanjaa (Sidi Mohammed Ben Abdellah University)

저널정보: 대한신경집중치료학회 Journal of Neurocritical Care Journal of Neurocritical Care Vol.14 No.2

발행연도: 2021.12

수록면: 88 - 97 (10page)

DOI: 10.18700/jnc.210019

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Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.

#Neuroleptic malignant syndrome #Intensive care unit #Antipsychotics #Mortality #Treatment

참고문헌 (45)

참고문헌 신청

Caroff SN / 1993 / Neuroleptic malignant syndrome / Med Clin North Am 77:185~202

Shalev A / 1989 / Mortality from neuroleptic malignant syndrome / J Clin Psychiatry 50:18~25

Modi S / 2016 / Neuroleptic malignant syndrome : complications, outcomes, and mortality / Neurocrit Care 24:97~103

American Psychiatric Association / 2013 / DSM-5: diagnostic and statistical manual of mental disorders / American Psychiatric Publishing

Gurrera RJ / 2007 / Meta-analytic evidence of systematic bias in estimates of neuroleptic malignant syndrome incidence / Compr Psychiatry 48:205~211

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