Anatolian Journal of Emergency Medicine
Yazarlar: Mehmet Muzaffer İSLAM, Hatice Şeyma AKÇA, Deniz TENGEREK
Konular:-
Anahtar Kelimeler:Sertraline,Neuroleptic Malignant Syndrome
Özet: Aim Neuroleptic Malignant Syndrome (NMS) is a potentially mortal disease which presents with hyperthermia, extrapyramidal symptoms, autonomic nervous system disorders and unconsciousness. Diagnosis is difficult, the most important determining factor is the sudden interruption of anti-Parkinson’s drugs and the reduction of their dosage. In this case report, we aimed to describe a case report of a patient with Neuroleptic Malignant Syndrome due to long- term use of sertraline. Case A 72 year old woman was brought to the emergency department with a complaint of confusion and fever. The patient was confused and looking apathetic. The patient was hypertensive, had a body temperature of 38.5 °C and had a stiff neck and motor weakness in the right upper and lower extremities. Urgent neurological intervention was not considered by the neurologists because cranial CT and diffusion MRI showed no signs of hemorrhage or infarction. Lumbar puncture was performed. No pathological sign was found in the cerebrospinal fluid. Meningitis and encephalitis was not considered by the infectious diseases department. During the follow-up, the patient’s relatives revealed that the patient was being given 100mg sertraline each day for the last 7 days. These symptoms were thought to be due to NMS, and the patient started to recover with antihypertensive, antipyretic and supportive fluid therapy. The patient was consulted to the psychiatry and was hospitalized to the intensive care unit with a diagnose of Neuroleptic Malignant Syndrome. Conlusion Neuroleptic Malignant Syndrome (NMS) is one of the neurological emergencies and can be mortal. It is usually seen due to use of antipsychotic drugs (like haloperidol) or abrupt discontinuation of dopaminergic drugs. All NMS cases might not show all the characteristic symptoms. It should be remembered that the early fluid and supportive therapy is crucial and NMS can be caused by different drugs.