Malignant Catatonia Versus Neuroleptic Malignant Syndrome.
adverse event
atypical antipsychotic
clinical case report
consultation liaison psychiatry
dantrolene
diferential diagnosis
emergency psychiatry
neuroleptic malignant syndrome (nms)
schizophrenia and other psychotic disorders
subtypes of catatonia
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
accepted:
21
06
2021
entrez:
26
7
2021
pubmed:
27
7
2021
medline:
27
7
2021
Statut:
epublish
Résumé
The clinical presentations of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) are similar, posing a diagnostic challenge. Here, we present a 58-year-old Caucasian male who presented to the emergency department with an altered mental state, fever, tachycardia, and rigidity. Labs were remarkable for elevated creatine phosphokinase (CPK) and leukocytosis. The patient was on a regimen of clozapine and cariprazine to manage schizophrenia, lorazepam to treat catatonia, and mirtazapine to treat insomnia and appetite stimulation. The patient was initially diagnosed with NMS after common metabolic, infectious, and substance-induced etiologies were ruled out. Within 72 hours of receiving dantrolene and lorazepam, the patient's fever, tachycardia, and other laboratory abnormalities resolved. However, when the patient's rigidity, waxy flexibility, mutism, and stupor persisted, the diagnosis was reconsidered and changed to MC. Our case discusses the overlapping clinical presentations of NMS and MC, demonstrating a diagnostic challenge.
Identifiants
pubmed: 34306883
doi: 10.7759/cureus.15818
pmc: PMC8295452
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e15818Informations de copyright
Copyright © 2021, Desai et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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