Abstract
Neuroleptic malignant syndrome (NMS) is a well-known complication of dopaminergic blockade. While there have been many case reports on Quetiapine-induced NMS, cerebrospinal fluid (CSF) abnormalities have never been documented. We report this case of bipolar affective disorder who had a previous history of Risperidone-induced parkinsonian rigidity. He presented to us 20 days after increasing lithium dose and starting Quetiapine and lamotrigine for an acute episode of mania. He had coarse tremors at rest, hyperthermia, altered sensorium and elevated creatine phosphokinase (CPK). CSF analysis showed elevated protein with no cells. A provisional diagnosis NMS was made and he was given bromocriptine. Patient’s hyperthermia resolved and CPK normalized with this treatment. He was subsequently discharged and is in follow up for his bipolar disorder.
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