Three Distinct Neuropsychiatric Syndromes Following Pineal Teratoma Resection

Introduction: Neuroleptic malignant syndrome (NMS), catatonia, and serotonin syndrome (SS) are unique neuropsychiatric conditions that share overlapping clinical features. Case Report: A 14-year-old boy presented to the hospital for surgical resection of a pineal gland teratoma. Following surgery, he developed cerebellar cognitive and affective syndrome, which led to dramatic behavioral changes, including suicidal behavior and agitation. Throughout his postsurgical course, he exhibited signs and symptoms concerning for overlapping NMS, catatonia, and SS. Discussion: Through this case we highlight the complex neurophysiology of three neuropsychiatric syndromes, review the treatment course for this patient, and raise awareness that these neuropsychiatric syndromes can occur concurrently.