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Catatonic variants, hyperthermic extrapyramidal reactions, and subtypes of neuroleptic malignant syndrome.
Ann Clin Psychiatry. 2007 Jan-Mar; 19(1):9-16.AC

Abstract

BACKGROUND

This case series study examines the hypothesis that neuroleptic malignant syndrome (NMS) is a heterogeneous condition including catatonic variants and non-catatonic pathological reactions to antipsychotics.

METHODS

Fourteen episodes of NMS were prospectively identified. Patients were examined for catatonia during the course of NMS. Close monitoring of catatonia episodes and suspected cases of evolving NMS for possible NMS development provided data on the pre-NMS clinical course. All NMS episodes received benzodiazepines. Episodes with catatonia diagnosed were compared with those without catatonia, noting their presentation, clinical course and responses to treatment.

RESULTS

Concurrent catatonia was diagnosed in 9 episodes. In 6 of them antecedent catatonia progressed to NMS following antipsychotic exposure (NMS of antipsychotic-converted catatonia). In 3 episodes, a parkinsonian-catatonic syndrome with fever and autonomic abnormality developed in reaction to antipsychotics (NMS of antipsychotic-induced catatonia). Catatonia was not diagnosed in 5 during the longitudinal course of NMS. A severe extrapyramidal reaction to antipsychotics with associated delirium preceded all 5 episodes. Seven of the 9 NMS episodes with catatonia and none of the 5 without catatonia showed significant responses to benzodiazepines.

CONCLUSIONS

The preliminary findings support the hypothesis that NMS is a heterogeneous condition including catatonic variants and non-catatonic hyperthermic extrapyramidal reactions to antipsychotics, differing in presentation, clinical course, and treatment responses.

Authors+Show Affiliations

Graylands Hospital and School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia. Joseph.Lee@health.wa.gov.au

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17453656

Citation

Lee, Joseph W Y.. "Catatonic Variants, Hyperthermic Extrapyramidal Reactions, and Subtypes of Neuroleptic Malignant Syndrome." Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, vol. 19, no. 1, 2007, pp. 9-16.
Lee JW. Catatonic variants, hyperthermic extrapyramidal reactions, and subtypes of neuroleptic malignant syndrome. Ann Clin Psychiatry. 2007;19(1):9-16.
Lee, J. W. (2007). Catatonic variants, hyperthermic extrapyramidal reactions, and subtypes of neuroleptic malignant syndrome. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, 19(1), 9-16.
Lee JW. Catatonic Variants, Hyperthermic Extrapyramidal Reactions, and Subtypes of Neuroleptic Malignant Syndrome. Ann Clin Psychiatry. 2007 Jan-Mar;19(1):9-16. PubMed PMID: 17453656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Catatonic variants, hyperthermic extrapyramidal reactions, and subtypes of neuroleptic malignant syndrome. A1 - Lee,Joseph W Y, PY - 2007/4/25/pubmed PY - 2007/6/30/medline PY - 2007/4/25/entrez SP - 9 EP - 16 JF - Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists JO - Ann Clin Psychiatry VL - 19 IS - 1 N2 - BACKGROUND: This case series study examines the hypothesis that neuroleptic malignant syndrome (NMS) is a heterogeneous condition including catatonic variants and non-catatonic pathological reactions to antipsychotics. METHODS: Fourteen episodes of NMS were prospectively identified. Patients were examined for catatonia during the course of NMS. Close monitoring of catatonia episodes and suspected cases of evolving NMS for possible NMS development provided data on the pre-NMS clinical course. All NMS episodes received benzodiazepines. Episodes with catatonia diagnosed were compared with those without catatonia, noting their presentation, clinical course and responses to treatment. RESULTS: Concurrent catatonia was diagnosed in 9 episodes. In 6 of them antecedent catatonia progressed to NMS following antipsychotic exposure (NMS of antipsychotic-converted catatonia). In 3 episodes, a parkinsonian-catatonic syndrome with fever and autonomic abnormality developed in reaction to antipsychotics (NMS of antipsychotic-induced catatonia). Catatonia was not diagnosed in 5 during the longitudinal course of NMS. A severe extrapyramidal reaction to antipsychotics with associated delirium preceded all 5 episodes. Seven of the 9 NMS episodes with catatonia and none of the 5 without catatonia showed significant responses to benzodiazepines. CONCLUSIONS: The preliminary findings support the hypothesis that NMS is a heterogeneous condition including catatonic variants and non-catatonic hyperthermic extrapyramidal reactions to antipsychotics, differing in presentation, clinical course, and treatment responses. SN - 1040-1237 UR - https://www.unboundmedicine.com/medline/citation/17453656/Catatonic_variants_hyperthermic_extrapyramidal_reactions_and_subtypes_of_neuroleptic_malignant_syndrome_ L2 - http://www.diseaseinfosearch.org/result/5187 DB - PRIME DP - Unbound Medicine ER -