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[Malignant syndrome in multiple system atrophy]

M Konagaya1, Y Goto, Y Matsuoka

  • 1Department of Neurology, Suzuka National Hospital, Mie, Japan.

No to Shinkei = Brain and Nerve
|June 1, 1997
PubMed
Summary

Malignant syndrome occurred in five patients with multiple system atrophy (MSA). Triggers include drug changes, heat, and complications, with dopaminergic drugs and dantrolene aiding recovery.

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Area of Science:

  • Neurology
  • Internal Medicine

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Malignant syndrome is a rare but serious complication in MSA patients.

Observation:

  • Five of fourteen MSA patients experienced eight episodes of malignant syndrome.
  • Episodes were linked to medication adjustments, environmental heat, and complications.
  • One patient developed fever after droxidopa administration, suggesting a pyrogenic effect.

Findings:

  • Extrapyramidal symptoms were present in four patients requiring antiparkinsonian therapy.
  • Dopaminergic drugs and dantrolene sodium facilitated recovery in four episodes.
  • Complications included dysautonomia, renal failure, and disseminated intravascular coagulation (DIC).

Implications:

  • Identifying triggers is crucial for preventing malignant syndrome in MSA.
  • Careful management of dopaminergic therapy and environmental factors is recommended.
  • Further research into droxidopa's pyrogenic potential in MSA is warranted.

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