Objective: Neuroleptic malignant syndrome (NMS) is a serious iatrogenic con
dition. This report reviews the world literature to characterize the syndro
me and evaluate factors that promote early detection and effective interven
tion. Method: The review identified 77 NMS cases (49 males, 27 females, 1 g
ender unknown); ages ranged from 0.9 to 18 years (mean 14.8 +/- 3.96). Univ
ariate and multiple regression analyses were applied to 38 variables to ide
ntify early signs of the disorder, to identify correlates of outcome, and t
o evaluate treatments. Results: The duration of NMS spanned from 1 to 119 d
ays. Nine percent of patients died and 20% resolved with serious sequelae.
Patients receiving low-potency neuroleptics had a poorer outcome (p = .01).
Fever was related to longer duration of illness (p = .03). Anticholinergic
s and bromocriptine were effective and without fatalities, but dantrolene w
as not useful in this sample of children and adolescents. Conclusions: Earl
y detection and appropriate interventions appear important in moderating th
e course and outcome of NMS.