Neuroleptic malignant syndrome presenting without hyperthermia: A case report of an atypical presentation

Neuroleptic malignant syndrome (NMS) is a life-threatening complication of antipsychotic medications. NMS is characterized by four key symptoms: Changes in mental status, muscular rigidity, hyperthermia, and autonomic dysfunction. Despite its key clinical symptoms, which are easily recognizable in a classic presentation, NMS occasionally does not present with all the described clinical characteristics. Atypical presentations of NMS pose a diagnostic conundrum for clinicians, leading to late recognition and treatment of a potentially treatable life-threatening condition. We present a case of NMS presenting without hyperthermia and autonomic instability but with elevated creatine kinase.