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Neuroleptic malignant syndrome due to risperidone misdiagnosed as status epilepticus

Ali Ertug Arslankoylu1, Meryem Ozlem Kutuk, Cetin Okuyaz

  • 1Mersin University Faculty of Medicine, Department of Pediatrics, Pediatric Intensive Care Unit, Mersin, Turkey.

Pediatric Reports
|November 5, 2011
PubMed

Insights

Neuroleptic malignant syndrome (NMS), a rare but serious condition, can be mistaken for status epilepticus in children. Early recognition of NMS in pediatric patients is crucial for timely and appropriate treatment.

Area of Science:

  • Pediatric Neurology
  • Pharmacology

Background:

  • Neuroleptic malignant syndrome (NMS) is a rare, life-threatening condition associated with antipsychotic medications.
  • Risperidone is an antipsychotic medication sometimes used in pediatric patients.

Observation:

  • A 9-year-old boy on high-dose risperidone presented with prolonged seizures, initially diagnosed as status epilepticus.
  • Physical examination revealed rigidity, diaphoresis, hyperthermia, and hypotension, with laboratory findings of leucocytosis and elevated creatine phosphokinase.
  • The patient's symptoms were ultimately attributed to NMS, not status epilepticus.

Findings:

  • NMS can mimic status epilepticus in children, particularly when electroencephalogram (EEG) monitoring is unavailable.
  • Prompt identification of NMS is critical, especially in patients with a history of neuroleptic medication use.

Implications:

  • This case highlights the importance of considering NMS in the differential diagnosis of pediatric seizures, especially in patients with risk factors.
  • Clinicians should inquire about neuroleptic medication use in children presenting with unexplained seizures or altered consciousness.
Keywords:
neuroleptic malignant syndromerisperidonestatus epilepticus.

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