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Neuroleptic malignant syndrome in two brothers with mental retardation

Abdurrahman Altındağ, Medaim Yanık, Melike Nebioğlu.

Abstract
Antipsychotic drugs have been widely used in patients with mental
retardation. Neuroleptic malignant syndrome (NMS) is a life-threatening
condition associated with dopaminergic blockage. Mentally retarded patients
using intramuscular antipsychotic injections have a significantly higher
risk of developing NMS. In this paper, NMS is reported in two brothers (ages
20 and 29) with mental retardation. Both cases had clinical manifestations
of NMS including muscle rigidity, hyperprexia, tremor, altered mental
status, acute renal failure, elevated creatinine phosphokinase levels and
autonomic instability after 3 weeks of haloperidol treatment. Haloperidol
was discontinued in both patients and supportive treatment and bromocriptine
was initiated. Clonazepam was also started in one of the patients. While the
younger patient who used clonazepam was discharged from the hospital 20 days
later, the older one died due to cardiovascular collapse.

Key words: neuroleptic malignant syndrome, mental retardation, antipsychotic, haloperidol



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