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[Neuroleptic malignant syndrome with rhabdomyolysis and muscle rupture]
Abstract:
We report a case of neuroleptic malignant syndrome (NMS) development after the ingestion of 960 mg of haloperidol in 18-year old male on the previous long-term neuroleptic treatment. Beside the severe rigidity and laboratory signs of rhabdomyolysis, firm swelling of gluteal and femoral areas, accompanied by pain and difficulty in the extension of the right leg, was noticed. The ultrasonography of the affected limb revealed partial rupture of quadriceps muscle. Since no signs of trauma or any other causes of muscle rupture were observed, we concluded that it developed due to the severe hypertonia and rhabdomyolysis in NMS. As there were no such cases previously reported, we wished to point out the possibility of muscle rupture development in NMS and propose the adequate diagnostic procedures and treatment.
Insights
Neuroleptic Malignant Syndrome (NMS) can cause severe muscle rigidity and rhabdomyolysis, potentially leading to muscle rupture. This case highlights a rare complication of NMS, emphasizing the need for prompt diagnosis and management.
Area of Science:
- Neurology
- Pharmacology
- Musculoskeletal Medicine
Background:
- Neuroleptic Malignant Syndrome (NMS) is a rare but life-threatening condition associated with antipsychotic medications.
- Long-term neuroleptic treatment increases the risk of developing NMS.
- Haloperidol is a commonly used antipsychotic agent that can precipitate NMS.
Observation:
- An 18-year-old male on long-term neuroleptic treatment developed NMS after ingesting 960 mg of haloperidol.
- The patient presented with severe muscle rigidity, rhabdomyolysis, and significant swelling and pain in the gluteal and femoral regions.
- Ultrasonography revealed a partial rupture of the quadriceps muscle in the affected limb.
Findings:
- The muscle rupture was attributed to severe hypertonia and rhabdomyolysis secondary to NMS.
- No evidence of trauma or other predisposing factors for muscle rupture was identified.
- This represents a previously unreported complication of Neuroleptic Malignant Syndrome.
Implications:
- Clinicians should consider the possibility of muscle rupture in patients with NMS, particularly those with severe hypertonia and rhabdomyolysis.
- Prompt diagnostic evaluation, including ultrasonography, is recommended for suspected muscle injury in NMS.
- Early recognition and management of NMS-induced muscle rupture are crucial for patient outcomes.