M. Paul, S. G. Michael, S. John and R. J. Lenox, “An Atypical Presentation of Neuroleptic Malignant Syndrome: Diagnostic Dilemma in a Critical Care Setting,” Respiratory Care, Vol. 57, No. 2, 2011, pp. 315-317.

has been cited by the following article:

• TITLE: Atypical Neuroleptic Malignant Syndrome: Pitfalls and Challenges in the Delirious Substance Abuser

  AUTHORS: Nirav N. Shah, Kristin G. Fless, Mikhail Litinski, Fariborz Rezai, Paul C. Yodice, Henry Rosenberg

  KEYWORDS: Atypical Neuroleptic Malignant Syndrome; Haloperidol; Ziprasidone; Dantrolene; Rhabdomyolysis; Creatinine Phosphokinase; Aminotransferase

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.2 No.2, April 19, 2012

  ABSTRACT: Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.