Haloperidol
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Neuroleptic malignant syndrome in an elderly patient with diffuse lewy body dementia: case report A 65-year-old woman developed neuroleptic malignant syndrome while receiving haloperidol for a multiple sclerosis (MS) flare; she was subsequently diagnosed with diffuse Lewy body dementia with increased sensitivity to neuroleptics. The woman, who had remitting-relapsing MS, was hospitalised for an MS flare. She received escalating doses of IV haloperidol to a total of 19mg over 24 hours in addition to MS therapy. Subsequently, she was transferred to an ICU for management of MS. Examination revealed a fever, dehydration, rigidity and myoclonus, while tests revealed acute kidney kidney injury and an elevated creatine kinase level. She was diagnosed with neuroleptic malignant syndrome [time to reaction onset not stated]. She was medically managed, and responded well. Her acute complications resolved; however, she subsequently began experiencing depressive symptoms, memory lapses and visual hallucinations. Assessment of her medical history revealed worsening short term memory loss over the past year, with bradykinesia, depression and visual hallucinations. Mental status testing revealed impaired recall, execution and visuospatial orientation. She was diagnosed with diffuse Lewy body dementia with sensitivity to neuroleptics with neuroleptic syndrome. She received donepezil, citalopram and valproic-acid, and her symptoms partially stabilised. Bansal N, et al. Diffuse lewy body dementia (DLBD): Missed diagnosis can be life threatening. Journal of the American Geriatrics Society 60 (Suppl. 4): S77 abstr. B13, Apr 2012. Available from: URL: http://dx.doi.org/10.1111/ 803072309 j.1532-5415.2012.04000.x - USA
0114-9954/10/1410-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 14 Jul 2012 No. 1410
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