Management of a trauma patient with alcohol withdrawal who developed neuroleptic malignant syndrome in Korea: a case report.

Journal of Trauma and Injury Pub Date : 2023-09-01 Epub Date: 2022-12-20 DOI:10.20408/jti.2022.0048
Byungchul Yu, Ji Yeon Lee, Yong Beom Kim, Hee Yeon Park, Junsu Jung, Youn Yi Jo
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引用次数: 0

Abstract

Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7°C after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.

一例因酒精戒断而出现抗精神病药物恶性综合征的创伤患者的治疗
抗精神病药物恶性综合征(NMS)是一种罕见但致命的疾病,死亡率很高。NMS的特征是精神状态改变、发烧、肌阵挛、自主神经功能障碍和肌酸酐磷酸激酶升高。临床表现可能与酒精相关症状、创伤、败血症、术后躁动或恶性高热混淆。一名69岁的男性患者因酒精戒断被送入手术室,以排除多重创伤后肠系膜损伤引起的感染性休克。他被怀疑是NMS患者,服用氟哌啶醇后体温突然升高至41.7°C。麻醉期间进行主动冷却和快速输液。NMS的延误诊断和治疗会导致灾难性的结果。因此,如果患者既往病史未知或出现提示NMS的临床症状,则必须考虑早期治疗。
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