Key result
Two severe cases of neuroleptic malignant syndrome were initially misdiagnosed as sepsis and midbrain infarction, highlighting the potential for diagnostic confusion.
Case Report (n=2)
Neuroleptic malignant syndrome can present with diverse clinical features leading to diagnostic confusion with other disorders like sepsis or midbrain infarction.
Diagnostic vigilance for neuroleptic malignant syndrome is warranted in atypical sepsis or stroke presentations; case reports leave open the prevalence of misdiagnosis.
The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to major tranquilizer drugs characterised by hyperpyrexia, extrapyramidal disorders and altered consciousness. First described in 1968 by Delay and Deniker, early case reports suggested a mortality of between 20 and 30%. Though the syndrome is now more widely recognised, the diversity of its clinical features may not always be appreciated and may lead to diagnostic confusion with other, more common, disorders. We report on two severe cases of NMS: in the first the diagnosis was initially thought to be sepsis from a urinary tract infection, and in the second the primary clinical diagnosis was of a mid brain infarction.
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Saunders et al. (1993) conducted a case report in Neuroleptic malignant syndrome (n=2). Major tranquilizer drugs was evaluated. Two severe cases of neuroleptic malignant syndrome were initially misdiagnosed as sepsis and midbrain infarction, highlighting the potential for diagnostic confusion.
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