Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic complication, arising as an idiosyncratic reaction to medications that block D2 receptors [8]. Clinically it is characterized by fever, extrapyramidal symptoms (mainly rigidity), impaired consciousness, and dysautonomia. NMS is not dose-dependent and can occur at any time during treatment with antipsychotic drugs, however usually presents within the first two weeks. The incidence is up to 2,4% among patients receiving these drugs, while mortality (mostly as a result of autonomic complications), is reported to be up to 20% [9]. Hypertonia and subsequent rhabdomyolysis lead to leukocytosis and serum creatine kinase (CK) elevation, which are the main laboratory derangements seen in NMS [10]. NMS usually exhibits no distinguishing features on MRI. It is thought that a variety of factors, including concomitant infections, acute neurologic diseases or substance abuse may predispose to NMS [11].
In this case report we present a rare case of a patient with sCJD who developed NMS.
Table 1. Criteria for probable sporadic Creutzfeldt-Jakob disease [12].