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[Neuroleptic malignant syndrome with rhabdomyolysis and muscle rupture]

S Nikić, J Jović-Stosić, S Vucinić

    Vojnosanitetski Pregled
    |July 31, 2001
    PubMed

    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.

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