Letter

Video of dantrolene effectiveness on neuroleptic malignant syndrome associated muscular rigidity and tremor

Miran Brvar^1,2 and Matjaz Bunc^2,3

¹Poison Control Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia

²Institute for Pathophysiology, Medical Faculty, Zaloska cesta 4, 1000 Ljubljana, Slovenia

³Department for Cardiology, University Medical Center Ljubljana, Zaloska cesta 7, Ljubljana, Slovenia

author email corresponding author email

Critical Care 2007, 11:415doi:10.1186/cc5907

Published:	1 June 2007

See related research by Reulbach et al.,http://ccforum.com/content/11/1/R4 and related letter by Roberts and Roberts, http://ccforum.com/content/11/3/413

First 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.