The evaluation and management of patients with neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is an infrequent but potentially life-threatening neurologic emergency. NMS first was described in association with the use of the neuroleptic haloperidol in 1960 by Delay et al [1]. Subsequently, NMS has been associated with a variety of other neuroleptics, a few antinausea agents, and other compounds that affect central dopaminergic neurotransmission. Since its initial description, some aspects of NMS remain poorly understood, whereas others are controversial partly because of their infrequent occurrence and heterogeneous nature. Because of this clinical variability and frequently accompanying concurrent medical problems, high clinical suspicion is needed for a prompt diagnosis, thereby allowing immediate treatment, which may be life saving.