Wednesday, 6 October 2010

MRCP revision battle 25.1: Neuroleptic Malignant Syndrome

Having been blessed by a set of on-calls with some nice interesting cases I'm full of enthusiasm for today's battles, so lets get on with it!

MRCP revision battle 25.1: Neuroleptic malignant syndrome
MRCP revision battle 25.2: Behcets disease
MRCP revision battle 25.3: Subarachnoid haemorrhage
MRCP revision battle 25.4: Normal pressure hydrocephalus
MRCP revision battle 25.5: Gas gangrene
MRCP revision battle 25.6: Methaemoglobinaemia
MRCP revision battle 25.7: The weeverfish

MRCP revision battle 25.1: Neuroleptic malignant syndrome

A nice straightfoward battle to begin with...

Neuroleptic malignant syndrome is a life-threatening condition associated with use of antipsychotic drugs.

Symptoms and signs include:
  • hyperthermia
  • rigidity/muscle cramps
  • extrapyramidal signs
  • autonomic dysfunction (labile BP, sweating, urinary incontinence
  • confusion

Investigations show:
  • raised CK
  • raised WCC

Treatment is:
  • cooling
  • dantrolene (a muscle relaxant; note dantrolene is also used in malignant hyperthermia, which will be one of tomorrows battles)

Now on to a slightly less straightforward battle, Behcets disease...