The neuroleptic malignant syndrome--a review

The neuroleptic malignant syndrome (NMS) is an uncommon disorder characterised by muscular stiffness and hyperthermia. It is caused by the administration of neuroleptics or by the acute withdrawal of levodopa therapy in idiopathic Parkinson's disease. An identical syndrome may be seen rarely in untreated catatonic schizophrenia. Shock, respiratory failure and myoglobinuria occur sometimes with serious consequences. Treatment should include active cooling measures and the administration of dopamine agonists. Dantrolene may also be of benefit in severe cases.