[Neuroleptic malignant syndrome and related conditions]

Neuroleptic malignant syndrome is characterised by muscular rigidity, fever and signs of severe vegetative nervous system involvement. Its etiopathogenesis is still unclear and the disease is potentially fatal. Its clinical aspects, which are often only partially manifested, make it difficult to formulate a correct diagnosis in time, not least due to the problem of differential diagnosis with other syndromes with similar symptoms but a different pathogenesis, psychopathology and therapy: acute lethal catatonia, fatal acute delirium, heat-stroke, malignant hyperthermia. The speed of the diagnosis is vital for effective therapy, but this is made even more difficult by the need approach. The paper presents eleven case studies; after an analysis of the numerous clinical aspects of the syndrome and the definition of its diagnostic parameters, an appropriate therapeutic protocol is outlined. Lastly, the problem of retreatment using a neuroleptic of the same or a different class is discussed once the acute phase has been overcome.