Document Detail

Neuroleptic malignant syndrome following cardiac surgery: successful treatment with dantrolene.
MedLine Citation:
PMID:  12965323     Owner:  NLM     Status:  MEDLINE    
Neuroleptic malignant syndrome (NMS) is a rare idiosyncratic reaction to neuroleptic drugs, which is potentially fatal. It has been occasionally reported that NMS occurs subsequently after surgery. We report a case of a 53-year-old male patient who developed NMS following cardiac surgery due to the resumption of zotepine. The patient was attacked with hyperthermia, sweating, significant shivering, trembling of the fingers, disturbed consciousness and extreme muscle rigidity after the resumption of zotepine. Furthermore, laboratory measurements revealed increased levels of serum blood urea nitrogen, creatinine and creatine phosphokinase. In addition, elevation in white blood cell counts and myoglobinemia were also observed. After a diagnosis of NMS was established, administration of zotepine was stopped and treatments with administration of dantrolene and a large amount of fluid infusion intravenously were started. Following these treatments, the clinical symptoms subsided and the laboratory findings improved without need for hemodialysis. Dantrolene, which is able to effectively impede the abnormal flow of calcium from the sarcplasmic reticulum into the muscle cytoplasm, was beneficial to reduce the clinical symptoms of NMS. We hereby present a patient with NMS following cardiac surgery, and discuss its subsequent management.
Shigetoshi Mieno; Kunio Asada; Hitoshi Horimoto; Shinjiro Sasaki
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  24     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-10     Completed Date:  2003-12-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  458-60     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan.
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MeSH Terms
Dantrolene / therapeutic use*
Heart Septal Defects, Atrial / surgery
Middle Aged
Muscle Relaxants, Central / therapeutic use*
Neuroleptic Malignant Syndrome / drug therapy*,  etiology
Postoperative Complications / drug therapy*
Reg. No./Substance:
0/Muscle Relaxants, Central; 7261-97-4/Dantrolene

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