Neuroleptic Malignant Syndrome (NMS)

Your Path

  • Neuroleptic Malignant Syndrome (NMS)


  • Exposure to haldol, chlorpromazine, other typical or atypical neruoleptics/anti-psychotics
  • More common w/high dose or soon after rx/dose change, but also idiosyncratic→ occurring after years of rx
  • Sx progress over several d


  • Fluctuating delirium→ aggitated or stupor/alert mutism to coma

Physical Exam Findings

  • Pale and sweaty
  • Autonomic instability w/hypertension, tachycardia, tachypnea
  • Temp can be > 41.1c
  • Mental status on spectrum from agitated to coma
  • Generalized lead-pipe type muscular rigidity
  • Decreased reflexes