Abstract
Electroconvulsive therapy can be effective in severe or treatment resistant neuroleptic malignant syndrome patients. Anesthesia and use of muscle relaxant agents for electroconvulsive therapy in such patients may encounter anesthesiologists with specific challenges. This case report describes successful management of anesthesia in 28-year-old male patient undergoing eight electroconvulsive therapy sessions for treatment of neuroleptic malignant syndrome.
Highlights
Neuroleptic malignant syndrome (NMS) is a rare, unpredictable, and potentially fatal complication of certain antipsychotic medications
Typical characteristics consist of hyperthermia, altered level of conscious, muscle rigidity, catatonia, autonomic dysfunction, and elevation of Creatine Kinase (CK) level
There are a known sameness between the clinical symptoms of NMS and malignant hyperthermia (MH) [6]; several reports have incited some controversy regarding the safety of the use of known triggering agents of MH such as succinylcholine in patients with a history of NMS [6,7,8]
Summary
Neuroleptic malignant syndrome (NMS) is a rare, unpredictable, and potentially fatal complication of certain antipsychotic medications. Bromocriptine, dantrolene, and benzodiazepines are effective in the treatment of NMS [2, 3]. There are a known sameness between the clinical symptoms of NMS and malignant hyperthermia (MH) [6]; several reports have incited some controversy regarding the safety of the use of known triggering agents of MH such as succinylcholine in patients with a history of NMS [6,7,8]. Anesthesia and muscle relaxation for ECT in such patients poses specific challenges to anesthesiologists.
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