TY - JOUR
T1 - Neuroleptic malignant syndrome in patients with non-herpetic viral encephalitis. Study of 7 cases
AU - Serrano-Dueñas, Marcos
PY - 2002
Y1 - 2002
N2 - Background: Our aim was to consider the possibility that patients with viral non-herpetic viral encephalitis develop the neuroleptic malignant syndrome (NMS) and determine the indispensable elements to diagnose it. Patients and Method: Seven patients with this type of encephalitis whose clinical picture fulfilled the criteria for NMS were evaluated. The control group consisted of 17 patients with the same type of encephalitis who had been randomly selected from the Neurological Service of a 3rd level hospital. We compared blood leukocyte numbers, cerebrospinal fluid (CSF) findings, axilar temperature, creatine kinase (CK) values and number of days of hospitalisation. Results: There were 5 males and 2 females with the mean age of 26 years. The control group consisted of 10 males and 7 females with the mean age of 37.52 years. Patients developed NMS after they were exposed to a mean doses of 17.85 mg of haloperidol with a latency (up to onset of symptoms) of 27.42 hours. In patients with NMS, the total number of leukocytes was increased (p < 0.003) as was that of neutrophils (p < 0.0003); the CSF protein level was increased (p < 0.02) whereas the CSF glucose level was reduced (p < 0.004); hyperpyrexia was higher (p < 0.000001); serum CK levels were higher (p < 0.000001), and, finally, NMS patients spent more days in hospital (p < 0.0002) than the control group. Conclusions: Patients with non-herpetic viral encephalitis can develop NMS after being exposed to relatively low doses of haloperidol and after a short latency period. The criteria typical of NMS including rigidity, hyperpyrexia, autonomic instability, altered consciousness and high CK levels are critical elements for its diagnosis. Moreover, these patients had high protein and low glucose CSF levels and they require more days of hospitalisation.
AB - Background: Our aim was to consider the possibility that patients with viral non-herpetic viral encephalitis develop the neuroleptic malignant syndrome (NMS) and determine the indispensable elements to diagnose it. Patients and Method: Seven patients with this type of encephalitis whose clinical picture fulfilled the criteria for NMS were evaluated. The control group consisted of 17 patients with the same type of encephalitis who had been randomly selected from the Neurological Service of a 3rd level hospital. We compared blood leukocyte numbers, cerebrospinal fluid (CSF) findings, axilar temperature, creatine kinase (CK) values and number of days of hospitalisation. Results: There were 5 males and 2 females with the mean age of 26 years. The control group consisted of 10 males and 7 females with the mean age of 37.52 years. Patients developed NMS after they were exposed to a mean doses of 17.85 mg of haloperidol with a latency (up to onset of symptoms) of 27.42 hours. In patients with NMS, the total number of leukocytes was increased (p < 0.003) as was that of neutrophils (p < 0.0003); the CSF protein level was increased (p < 0.02) whereas the CSF glucose level was reduced (p < 0.004); hyperpyrexia was higher (p < 0.000001); serum CK levels were higher (p < 0.000001), and, finally, NMS patients spent more days in hospital (p < 0.0002) than the control group. Conclusions: Patients with non-herpetic viral encephalitis can develop NMS after being exposed to relatively low doses of haloperidol and after a short latency period. The criteria typical of NMS including rigidity, hyperpyrexia, autonomic instability, altered consciousness and high CK levels are critical elements for its diagnosis. Moreover, these patients had high protein and low glucose CSF levels and they require more days of hospitalisation.
KW - Dopaminergic receptors
KW - Encephalitis
KW - Hyperpyrexia
KW - Neuroleptic malignant syndrome
KW - Rigidity
UR - http://www.scopus.com/inward/record.url?scp=0036319701&partnerID=8YFLogxK
U2 - 10.1016/S0025-7753(02)72282-3
DO - 10.1016/S0025-7753(02)72282-3
M3 - Article
C2 - 11809148
AN - SCOPUS:0036319701
SN - 0025-7753
VL - 118
SP - 62
EP - 64
JO - Medicina Clinica
JF - Medicina Clinica
IS - 2
ER -