Talk:Neuroleptic malignant syndrome

From the public domain resource at http://www.ninds.nih.gov/health_and_medical/disorders/neuroleptic_syndrome.htm

NMS and Sinemet withdrawal?

I think NMS can also be caused by withdrawal from Sinemet, but I don't know enough about it to make the edit. Can a physician or other expert comment?

Sarah Waggoner 21:21, 26 September 2007 (UTC)

http://www.rxlist.com/cgi/generic/sinemet_wcp.htm It seems so - this source IS reliable, but I'm sure there are high quality ones.

It is also worth noting that the condition can occur on *withdrawing* from Neuroleptics (antipsychotics) too. Although some might say that it is 'Malignant Catatonia' in this case. And there may well be a crossover between NMS and Malignant Catatonia too! I might find sources later and add this to the article if not already there. Buckethed (talk) 01:04, 14 December 2007 (UTC)

Dubious

I question the validity of the statement "NMS should be ruled out in the case of acute behaviour change of any person on antipsychotic medication". Isn't the intended effect of antipsychotic medication to produce behavioural change, so a change in the behaviour of people starting treatment (the people most likely to be afflicted with NMS) shouldn't rule out anything — it should be expected. Neitherday (talk) 04:03, 17 December 2007 (UTC)

I just read it again and what I meant was:

Acute and significant behaviour change/deterioration (eg: over a day or less) in someone who has otherwise been stable for a period of time on antipsychotics. (i.e. the dose hasn't been changed and the person hasn't deteriorated because of drug-taking or noncompliance)

I'll get a ref and figure out the best way to word it exactly. Is that clearer? cheers, Casliber (talk · contribs) 04:38, 17 December 2007 (UTC)

I get it now, thank you. :) Neitherday (talk) 06:34, 17 December 2007 (UTC)

Fever vs Hyperthermia

The rise in core temperature is really hyperthermia due mostly to excessive muscle activity and not fever, although these two are frequently mixed up (even the mesh definition for Neuroleptic malignant syndrome says 'fever'). Maybe this should be changed, although the useful mnemonic would also need to be altered. —Preceding unsigned comment added by T vanhove (talk • contribs) 09:39, 30 December 2007 (UTC)

"Supportive?"

The article states, "Treatment is generally supportive." I have no idea what this means. Perhaps it is medical jargon. Perhaps it is a mistake. Either way, I think it could use some clarification. David (talk) 14:10, 24 March 2009 (UTC)

It means that treatment targets whatever symptoms the patient is having, instead of targeting the cause. Giving IV fluids, pain management, etc. Peetiemd (talk) 03:05, 13 May 2009 (UTC)

Potential Revisions

Make sure to use proper sentence structure. For example, the phrase “Occurs in 0.1-0.2% of patients receiving conventional anti-psychotics (e.g., butyrophenones [especially haloperidol], phenothiazines, thioxanthenes)” under the “Epidemiology” section is not a complete sentence. Also, consider expanding this section. Including other factors, such as age and gender distributions, would help your article (being young and male may be risk factors for the development of NMS—you can find this information at the url: http://cat.inist.fr/?aModele=afficheN&cpsidt=2894011). Also, how do dantrolene sodium, bromocriptine, and apomorphine function to treat NMS? It is good that you have linked them to other Wikipedia articles, but a short description specifying their use is perhaps needed. Bergaa7 (talk) 02:14, 24 November 2009 (UTC)

I found different data on the occurrence of NMS from what you provide in the "Epidemiology" section. Instead of .1-.2% of patients receiving neuroleptics, I found data suggesting .2-3.23% of these patients experience NMS. The paper that had this data has other epidemiological data that could be helpful in expanding your "Epidemiology" section, along with the suggestions by Bergaa7. The paper can be found at: [[1]].

--Philades (talk) 23:16, 28 November 2009 (UTC)

you mention many signs and symptoms but you don't really go into how NMS actually causes those symptoms. further elaboration on that can help readers understand more about the pathology and what the disease is connected with physically. perhaps you can throw that into the "pathophysiology" section. the mnemonic device was pretty nifty though. it seems that those are the most COMMON symptoms though, so you should mention that they aren't just limited to those. Also, you say they are "features" which kind of puts a positive connotation. perhaps another synonym would be more appropriate? Under "causes", it is unclear whether this adverse reaction is random, genetic, or allergenic. is there any research that sheds light on this subject? "differential diagnosis" also seems to be out of place under the "causes" section. it would probably be better in the "signs and symptoms" section. "prognosis" and "epidemiology" seem so short that they can be integrated into other sections of the article. Perhaps elaborating on them or finding another place to put them could help. Good work so far!

Justindchien (talk) 01:45, 29 November 2009 (UTC)