Recognition, assessment and management of neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a potentially fatal idiosyncratic complication of neuroleptic treatment. It was first described in 1968 by Delay and Deniker, and is characterized by hyperthermia, extrapyramidal signs, autonomic dysfunction and altered mentation. They reported that 0.5% to 1.0% of the patients on neuroleptic therapy developed NMS. Several retrospective studies have reported the frequency of NMS between 0.02% to 2.44%. These variations in the incidence of NMS may be due to difference in patient population, awareness and experience of clinicians, prescribing habits, different diagnostic criteria, or methodological differences in survey methods.