Neuroleptic malignant syndrome in children and adolescents

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.