Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic
complication, arising as an idiosyncratic reaction to medications that
block D2 receptors [8]. Clinically it is characterized by fever,
extrapyramidal symptoms (mainly rigidity), impaired consciousness, and
dysautonomia. NMS is not dose-dependent and can occur at any time during
treatment with antipsychotic drugs, however usually presents within the
first two weeks. The incidence is up to 2,4% among patients receiving
these drugs, while mortality (mostly as a result of autonomic
complications), is reported to be up to 20% [9]. Hypertonia and
subsequent rhabdomyolysis lead to leukocytosis and serum creatine kinase
(CK) elevation, which are the main laboratory derangements seen in NMS
[10]. NMS usually exhibits no distinguishing features on MRI. It is
thought that a variety of factors, including concomitant infections,
acute neurologic diseases or substance abuse may predispose to NMS
[11].
In this case report we present a rare case of a patient with sCJD who
developed NMS.
Table 1. Criteria for probable sporadic Creutzfeldt-Jakob
disease [12].