Neuroleptic malignant syndrome without typical symptoms, which was difficult to distinguish from heatstroke : a case report

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  • Nagamura Tatsunori
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Nakano Satoshi
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Inoue Kazushige
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Hishikawa Tsuyoshi
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Yoshioka Hayato
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Okada Ichiro
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center
  • Hasegawa Ejyu
    Department of Trauma and Critical Care Medicine, National Disaster Medical Center

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Other Title
  • III度熱中症との鑑別が困難であった典型的症状を欠いた悪性症候群の1例

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<p>A-56-year-old man on antipsychotic medication was admitted to our emergency department with a complaint of consciousness disturbance. We started treatment for heatstroke ; however, fever and creatine phosphokinase level did not improve. Further, lip dyskinesia and eyeball rolling were observed. We suspected neuroleptic malignant syndrome without muscle rigidity, and administered dantrolene from day 6. Although fever and creatine phosphokinase level improved, consciousness disturbance was prolonged. Neuroleptic malignant syndrome is difficult to distinguish from heatstroke because of overlapping symptoms. It is important to consider neuroleptic malignant syndrome when a patient on antipsychotic medication presents with symptoms indicating a heatstroke.</p>

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