[Neuroleptic malignant syndrome in users of risperidone]

Neuroleptic malignant syndrome is a potentially life-threatening complication of neuroleptic therapy. Three nursing-home residents who suffered from multiple somatic disorders and dementia, two men aged 78 and 76 years respectively and a woman aged 72 years, developed neuroleptic malignant syndrome following the use of risperidone. The first two patients presented with severe muscular pain. Initially, none of them exhibited high fever and so it is debatable whether the diagnosis 'neuroleptic malignant syndrome' can be excluded in the absence of fever. A review of the literature indicates that the syndrome can easily be mistaken for an infection. Patients with extrapyramidal side effects as a result of earlier use of neuroleptics seem to be more vulnerable to developing neuroleptic malignant syndrome. Patients using neuroleptics who become ill with an altered level of consciousness, sweating and muscular rigidity, should at least have their blood tested for the level of creatine phosphokinase activity. Furthermore, pain might be an initial symptom. Treatment of the neuroleptic malignant syndrome failed in all three patients, and they died.