Mortal postpartum neuroleptic malignant syndrome

Abstract

Neuroleptic malignant syndrome is a serious side effect caused by antipsychotic medications. Neuroleptic malignant syndrome is believed to be triggered by neuroleptic blockade of dopaminergic receptors located in the hypothalamus and basal ganglia. The incidence of neuroleptic malignant syndrome with conventional antipsychotic agents has been reported to vary from 0.02-2.44%. Manifestations of this syndrome include severe muscle rigidity and high temperature with any of the following symptoms: dysphagia, tremor, incontinence, changes in the level of consciousness, ranging from confusion to coma, mutism, tachycardia, elevated or labile blood pressure, leukocytosis and laboratory evidence of muscle injury characterized by elevated creatinine-phosphokinase (CPK). In this study, we present a case of postpartum neuroleptic malignant syndrome which ended in the death of the patient, and review the literature.