Objective: Neuroleptic malignant syndrome (NMS) is a
life-threatening reaction to neuroleptics. Several prospective studies
have reported NMS occurrence rates ranging from 0.07% to 2.2% of patients
receiving neuroleptics. However, few occurrences of NMS have been reported
in cancer patients despite frequent complications of cancer and its
treatment by mental disorders managed with neuroleptic drugs. Exhaustion,
dehydration, and malnutrition are considered risk factors for NMS, and
cancer patients represent a high risk group for NMS.
Methods: We describe a patient with metastatic chondrosarcoma
who had received frequent neuroleptic injections prior to brain surgery
and developed NMS in the intensive care unit immediately after surgery.
The patient showed delirium, hyperpyrexia, tachycardia, diaphoresis, and
extrapyramidal symptoms. After a diagnosis of NMS was made, supportive
care and careful monitoring were carried out, and the patient recovered
over an interval of 11 days.
Results and significance of the research: Clinical NMS
studies have been conducted mainly in psychiatric units, but NMS can occur
wherever psychotropic drugs are administered. NMS can be difficult to
diagnose due to multiple complicating factors in cancer treatment, but the
diagnosis is highly important given the risk of death. Recognition of
prodromal NMS symptoms can facilitate actions to decrease morbidity and
mortality. It is suggested that special attention to cancer patients
undergoing psychopharmacologic treatment is required in clinical oncologic