NMS can occur with typical or atypical agents (especially clozapine).Antipsychotics are the most common cause:.Treatment involves both augmentation of D2 signaling in the brain, as well as providing muscle relaxants to reduce peripheral muscle tone. ( 28144147)Ī combination of excess motor tone plus dysautonomia may precipitate other features of neuroleptic malignant syndrome, including rhabdomyolysis and hyperthermia. Dopamine alterations within the reticular activating system may cause alterations in consciousness (e.g., mutism, coma).Dopamine deficiency in the hypothalamus may cause autonomic dysfunction.Dopamine deficiency within striatal dopamine pathways in the basal ganglia may cause Parkinsonian-type symptoms (e.g., lead-pipe rigidity). Neuroleptic malignant syndrome seems to result from a deficiency of signaling via D2 dopamine receptors in the brain: It can present as a life-threatening emergency, and is often challenging to diagnose. As its name implies, NMS is often related to neuroleptic agents (i.e., antipsychotic medications) and is manifest by mental status changes, hyperthermia, rigidity, and autonomic dysfunction.
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