Related Experiment Video

Updated: Aug 9, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
07:22

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Neuroleptic malignant syndrome associated with metoclopramide in a burn patient

Ryan Nachreiner1, Jeroen Balledux, Madeline Zieger

  • 1Richard M. Fairbanks Burn Unit, Wishard Memorial Hospital, Indiana University, School of Medicine, Indianapolis, Indiana 46202-5124, USA.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|March 29, 2006
PubMed

Insights

Neuroleptic malignant syndrome (NMS), a rare but serious reaction to neuroleptic drugs, can mimic burn symptoms. Early recognition and treatment, including drug withdrawal and supportive care, are crucial for patient survival.

Area of Science:

  • Medical Science
  • Toxicology
  • Emergency Medicine

Background:

  • Neuroleptic malignant syndrome (NMS) is a rare, life-threatening condition associated with neuroleptic medications.
  • NMS symptoms can overlap with burn pathophysiology, potentially delaying diagnosis in burn patients.

Observation:

  • A 27-year-old male with 15% TBSA burns developed NMS due to metoclopramide administration.
  • The patient's NMS symptoms resolved promptly following recognition and appropriate treatment.

Findings:

  • Immediate withdrawal of neuroleptic agents is the cornerstone of NMS treatment.
  • Supportive care, temperature reduction, and dopamine balance restoration are essential management strategies.
  • Pharmacological interventions like benzodiazepines, dantrolene, and dopaminergic agents are considered.

Implications:

  • Burn surgeons and unit personnel must be aware of NMS to ensure timely diagnosis and intervention.
  • Early treatment initiation significantly improves outcomes and can be life-saving for patients presenting with NMS.
  • This case highlights the importance of considering NMS in burn patients with unexplained clinical deterioration.

Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists01:28

Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists

Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
Burn Injuries01:22

Burn Injuries

Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...