Neuroleptic Malignant Syndrome and Extremely High Creatine Kinase Level; 2 Episodes in One Patient: A Case-Report

Background: The neuroleptic malignant syndrome (NMS) is an idiosyncratic abnormality due to the use of dopamine antagonists. The most incriminated are antipsychotics, these drugs can be classified according to the incidence of this iatrogenic event. Amisulpride and Risperidone are not on the top of the list; they are not reported sufficiently in the literature because of the rarity of the event. Case presentation: We report, through this case-report, a patient who had two successive episodes of NMSs, this is a rare event in psychiatric practice that let us take in consideration the genetic hypothesis of individual vulnerability. In addition, the plasmatic creatine kinase being at 50,000 iu/l is not very common and put our patient in a life-threatening situation. Conclusion: Although being rare, the neuroleptic malignant syndrome can occur multiple time in the same patient, having two NMS, a high ck plasmatic level, and dealing with its complications leads us more towards the genetic theory.