A Fatal Hypermetabolic Syndrome: Acute Dopamine Depletion Syndrome
Journal Title: Journal of Neurological Sciences-Turkish - Year 2007, Vol 24, Issue 4
Abstract
Objective: Neuroleptic malignant syndrome (NMS) is a rare and potentially lethal hypermethabolic disorder associated with the use of antipsychotic medications. A related syndrome “malignant syndrome” occurs in Parkinson’s disease patients whose medications have been reduced or abruptly discontinued. For this reason, some authors have suggested to rename the syndrome as “acute dopamine depletion syndrome (ADDS)”. In this report, ADDS and NMS are reviewed as one of the fatal hypermetabolic syndromes and the importance of earlier recognition and appropriate management of this syndrome, in order to reduce mortality and morbidity, is emphasized. Method: In this study, 5 cases (3 male, 2 female) with the age range of 29-62 years diagnosed as ADDS or NMS were presented in terms of clinical and laboratory findings and prognostic properties. Results: All cases had fever, confusional state, severe rigidity, autonomous dysfunctions, and high CK levels as 7-40 times higher than the normal value. Three cases with the diagnosis of psychosis had a history of high dose neuroleptic exposure and one case with Parkinson’s disease had a history of abrupt discontinuation of dopaminergic therapy. In one case with chronic alcoholism history, NMS developed after low dose neuroleptic medication on the basis of malnutriation and dehidration. Two cases were lost due to complications and autonomic dysfunction and 3 cases showed partial improvement after supportive and symptomatic therapy. Conclusion: ADDS and NMS are rare and potentially lethal hypermethabolic disorder. Keeping the syndromes in mind will be very usefull for earlier recognition and appropriate management and will reduce mortality and morbidity.
Authors and Affiliations
Feray GULEC, Nur YUCEYAR, Hadiye SIRIN, Ayse KOCAMAN, Emre KUMRAL
Keywords
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