Psychiatry

Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic reaction, commonly associated with neuroleptic treatment. It is potentially fatal, with mortality rates of 10 to 20%. Most fatalities occur early -pneumonia and renal failure account for the majority of deaths during this stage. Patients who survive NMS usually completely recover. 2 Long-term neurological sequelae after an episode of NMS are rare, and their clinical manifestations diverse. However, there has been no systematic research on the subject. Thus, the incidence and prevalence of post-NMS neurological sequelae are unknown. Case reports indicate that presentations vary from subtle neuropsychological deficits such as transient or persistent cognitive impairment, including organic amnesic syndromes, 3-5 to widespread cerebellar damage. 2,6,7 Persistent abnormal involuntary movement disorders, such as dyskinesias, rigidity, hypertonia, dysarthria, and tremors following NMS have also been described. This report describes the case of a young man with bipolar disorder, who recovered from NMS, but subsequently developed extensive neurological sequelae.