Letter
Video of dantrolene effectiveness on neuroleptic malignant syndrome associated muscular rigidity and tremor
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* Corresponding author: Miran Brvar miran.brvar@kclj.si
1 Poison Control Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
2 Institute for Pathophysiology, Medical Faculty, Zaloska cesta 4, 1000 Ljubljana, Slovenia
3 Department for Cardiology, University Medical Center Ljubljana, Zaloska cesta 7, Ljubljana, Slovenia
Critical Care 2007, 11:415 doi:10.1186/cc5907
Published: 1 June 2007First paragraph (this article has no abstract)
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal adverse reaction to neuroleptic drugs, including amisulpride [1,2]. NMS most commonly presents with increased body temperature, muscular rigidity of a 'lead pipe' nature, altered mental status and autonomic dysfunction. Other extrapyramidal movement disorders such as tremor and cogwheel phenomena are also frequently present. The treatment of NMS includes discontinuation of contributing drugs and supportive therapy, but specific treatment with dantrolene, bromocriptine, nondepolarizing neuromuscular paralysis and benzodiazepines, among other such agents, has been reported only anecdotally. A recent analysis of published case reports [3] evaluated the efficacy of dantrolene in NMS; it found that dantrolene, given as monotherapy, might be helpful in managing this syndrome if the premedication was a neuroleptic monotherapy. We present video evidence of the effectiveness of dantrolene in reducing muscular rigidity, tremor and cogwheel phenomena in a patient with NMS.