Anest. intenziv. Med. 2024;35(3):182-184 | DOI: 10.36290/aim.2024.031

A case of whole­‑body rigidity in a patient after orthopedic surgeryCase Report

Tlapáková K.1, Černá Pařízková R.1, 2, Astapenko D.1-3
1 Klinika anesteziologie, resuscitace a intenzivní medicíny Fakultní nemocnice v Hradci Králové
2 Lékařská fakulta v Hradci Králové, Univerzita Karlova
3 Fakulta zdravotnických studií, Technická fakulta v Liberci

In our case report, we present a case of swiftly manifesting malignant neuroleptic syndrome in a patient after orthopedic surgery who was treated for a new onset of delirium with a combination of antipsychotic drugs. Thanks to early diagnosis and treatment the patient didn't suffer any organ dysfunction and could have been discharged from our intensive care unit in two days back to the standard unit. The goal of this case report is to highlight this rare yet still life-threatening condition to our colleagues to help them take care of patients with such diagnoses in the future.

Keywords: malignant neuroleptic syndrome, acute dysautonomia, delirium, drug abuse, withdrawal syndrome.

Received: March 19, 2024; Revised: July 5, 2024; Accepted: July 16, 2024; Prepublished online: August 12, 2024; Published: October 7, 2024  Show citation

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Tlapáková K, Černá Pařízková R, Astapenko D. A case of whole­‑body rigidity in a patient after orthopedic surgery. Anest. intenziv. Med. 2024;35(3):182-184. doi: 10.36290/aim.2024.031.

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    References

    1. Wijdicks E. Neuroleptic malignant syndrome. UpToDate, Janet L Wilterdink (Ed), Wolters Kluwer, Last Update: May 26, 2022.
    2. Nováková M. Neuroleptický maligní syndrom - život ohrožující komplikace léčby antipsychotiky. Geriatrie a Gerontologie. 2019;(4):171-173.
    3. van Rensburg R, Decloedt EH. An Approach to the Pharmacotherapy of Neuroleptic Malignant Syndrome. Psychopharmacology Bulletin. 2019;49(1):84-91.
    4. Ware MR, Feller DB, Hall KL. Neuroleptic Malignant Syndrome: Diagnosis and Management. Prim Care Companion CNS Disord. 2018;20(1). Go to original source... Go to PubMed...
    5. Oruch R, Pryme IF, Engelsen BA, Lund A. Neuroleptic malignant syndrome: An easily overlooked neurologic emergency. Neuropsychiatric Disease and Treatment. 2017;(13):161-175. Go to original source... Go to PubMed...
    6. Látalová K, Praško J, Maršálek M. Varianty katatonie. Česká a Slovenská Neurologie a Neurochirurgie. 2009;72(6):518-524.
    7. Češková E, Horská K. Neuroleptický maligní syndrom v České republice. Česká a slovenská psychiatrie. 2023;119(3):98-101.
    8. Kuhlwilm L, Schönfeldt­‑Lecuona C, Gahr M, Connemann B, Keller F, Sartorius A. The Neuroleptic Malignant Syndrome - A systematic case series analysis focusing on therapy regimes and outcome. Acta Psychiatrica Scandinavica. 2020;142(3):233-241. Go to original source... Go to PubMed...
    9. Simon LV, Hashmi MF, Callahan AL. Neuroleptic Malignant Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482282/.
    10. Strawn JR, Keck PE Jr, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry. 2007 Jun;164(6):870-6. doi: 10.1176/ajp.2007.164. 6. 870. PMID: 17541044. Go to original source...
    11. Rodriguez S, Dufendach KA, Weinreib RM. Neuroleptic Malignant Syndrome or Catatonia? A Case Report. J Crit Care Med (Targu Mures). 2020 Aug 11;6(3):190-193. doi: 10.2478/jccm-2020-0025. PMID: 32864466; PMCID: PMC7430361. Go to original source... Go to PubMed...
    12. Komatsu T, Nomura T, Takami H, Sakamoto S, Mizuno K, Sekii H, et al. Catatonic Symptoms Appearing before Autonomic Symptoms Help Distinguish Neuroleptic Malignant Syndrome from Malignant Catatonia. Intern Med. 2016;55(19):2893-2897. doi: 10.2169/internalmedicine.55.6613. Epub 2016 Oct 1. PMID: 27725556; PMCID: PMC5088557. Go to original source... Go to PubMed...
    13. Kodadek L, Carmichael Ii SP, Seshadri A, Pathak A, Hoth J, Appelbaum R, et al. Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document. Trauma Surg Acute Care Open. 2022;7(1):e000836. Go to original source... Go to PubMed...
    14. De Guzman MM. (n.d.). Rhabdomyolysis Treatment & Management: Approach Considerations, Fluid Resuscitation, Prevention of Acute Kidney Injury and Renal Failure. Available from: https://emedicine.medscape.com/article/1007814-treatment?form=fpf#d7. Last Update: Feb 28, 2024.

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