A Malignant Neuroleptic Spectrum: Review of Diagnostic Criteria and Treatment Implications in Three Case Reports

Abstract

Prompt identification of cases of Neuroleptic Malignant Syndrome (NMS) pose a diagnostic and treatment challenge. Three hospital cases of neuroleptic toxicity were reviewed and compared across five published diagnostic criteria sets for NMS. Of these criteria sets, only Levenson's criteria led to the detection of NMS in two out of our three patients. This criteria set supports a NMS spectrum concept, allowing earlier diagnosis and intervention. Lorazepam was used as initial treatment, which provided significant improvement. Use of Levenson's criteria for early diagnosis of NMS and lorazepam for its treatment may be useful tools for the early management of NMS.