Neuroleptic malignant syndrome in a cervical spinal injury patient: a case report

Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic, and potentially fatal complication associated with the abrupt withdrawal of dopaminergic agents or the use of antidopaminergic medications that affect the hypothalamus and basal ganglia. Its hallmark features include severe hyperthermia, altered consciousness, skeletal muscle rigidity, and autonomic instability. We present the case of a young patient with a cervical spine injury who was admitted to the trauma intensive care unit (ICU). The patient developed a persistent high-grade fever that did not respond to standard interventions, which was ultimately attributed to NMS resulting from the administration of neuroleptic medications. Because of a high degree of clinical suspicion and the implementation of prompt therapeutic measures, the patient achieved a favorable clinical outcome. Early diagnosis and timely intervention are crucial in NMS due to its rapid clinical progression, particularly as the use of dopaminergic antagonists becomes more prevalent in ICU settings. This case highlights the diagnostic challenges of managing NMS alongside spinal trauma in the ICU, as NMS often mimics common postoperative and ICU-related complications, necessitating heightened clinical vigilance.