Neuroleptic Malignant Syndrome/Malignant Catatonia in Child Psychiatry: Literature Review and a Case Series

Neera Ghaziuddin, Melissa Hendriks, Paresh Patel, Lee E. Wachtel, Dirk M. Dhossche

Research output: Contribution to journalReview article

Abstract

Objective: To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents. Background: NMS and MC are life-Threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent. Some authorities believe that apart from the history of exposure to an AP medication, the two conditions are identical. The symptoms of NMS/MC include severe agitation, behavior disregulation, motor and speech changes, self-injury and aggression, autonomic instability, and a range of psychiatric symptoms (affective, anxiety, or psychotic symptoms). Patients may be misdiagnosed with another disorder leading to extensive tests and a delay in treatment. Untreated, the condition may be fatal in 10%-20% of patients, with death sometimes occurring within days of disease onset. Method: We describe the presentation and management of five children and adolescents with NMS/MC. Conclusion: MC and NMS are life-Threatening medical emergencies, which if diagnosed promptly, can be successfully treated with known effective treatments (benzodiazepines and/or electroconvulsive therapy).

Original languageEnglish (US)
Pages (from-to)359-365
Number of pages7
JournalJournal of Child and Adolescent Psychopharmacology
Volume27
Issue number4
DOIs
StatePublished - May 1 2017
Externally publishedYes

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Catatonia
Neuroleptic Malignant Syndrome
Child Psychiatry
Antipsychotic Agents
Affective Symptoms
Electroconvulsive Therapy
Diagnostic Errors
Aggression
Benzodiazepines
Psychiatry
Emergencies
Anxiety
History
Morbidity
Mortality
Wounds and Injuries

Keywords

  • adolescents
  • children
  • malignant catatonia (MC)
  • neuroleptic malignant syndrome (NMS)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Neuroleptic Malignant Syndrome/Malignant Catatonia in Child Psychiatry : Literature Review and a Case Series. / Ghaziuddin, Neera; Hendriks, Melissa; Patel, Paresh; Wachtel, Lee E.; Dhossche, Dirk M.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 4, 01.05.2017, p. 359-365.

Research output: Contribution to journalReview article

Ghaziuddin, Neera; Hendriks, Melissa; Patel, Paresh; Wachtel, Lee E.; Dhossche, Dirk M. / Neuroleptic Malignant Syndrome/Malignant Catatonia in Child Psychiatry : Literature Review and a Case Series.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 4, 01.05.2017, p. 359-365.

Research output: Contribution to journalReview article

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