%0 Journal Article
%T Neuroleptic Malignant Syndrome in a Patient with Tongue Cancer: A Report of a Rare Case
%A Osamu Baba
%A Kenji Yamagata
%A Yasushi Tomidokoro
%A Akira Tamaoka
%A Hiroyuki Itoh
%A Toru Yanagawa
%A Kojiro Onizawa
%A Hiroki Bukawa
%J Case Reports in Dentistry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/542130
%X Background. Neuroleptic malignant syndrome (NMS) is a rare but life-threatening complication of neuroleptic drugs, which are used widely in head and neck cancer (HANC) patients who develop delirium. Methods and Results. Postoperative delirium in a 39-year-old man with tongue cancer was treated with haloperidol and chlorpromazine. Three days after the first administration of antipsychotics, the patient exhibited elevated body temperature, autonomic and extrapyramidal symptoms, and impaired consciousness. A definitive diagnosis was made using the research diagnostic criteria for NMS in the DSM-IV, and the antipsychotics were immediately discontinued. The patient was given dantrolene and bromocriptine to treat the NMS. The patient¡¯s hyperthermia, elevated creatinin kinase (CK), and muscle rigidity improved gradually, with all symptoms of NMS resolving completely by 13 days after the diagnosis. Conclusions. HANC surgeons must be alert for early signs of NMS and use antipsychotics conservatively to avoid NMS and its potentially fatal outcome. 1. Introduction Neuroleptic malignant syndrome (NMS) is a rare but life-threatening disorder caused by an adverse reaction to neuroleptic (antipsychotic) drugs and characterized by hyperthermia, severe muscle rigidity, and changes in autonomic and mental status [1]. Most cases of clinical NMS have been reported by psychiatrists; however, NMS can occur in any setting in which psychotropic drugs are administered. In nonpsychiatric cases treated with neuroleptics, NMS can be difficult to diagnose, particularly because the symptoms are consistent with other, more expected, disorders. However, early diagnosis is extremely important to reduce the risk of death. The frequency of the syndrome ranges from 0.07 to 2.2% in patients treated with neuroleptic drugs, and the mortality is 10 to 30% [2, 3]. Although the frequency of NMS among patients taking neuroleptics has decreased, it remains a significant source of morbidity and mortality in this patient group [4]. To our knowledge, a few reports have been published about NMS in patients with head and neck cancer (HANC) [5, 6]. We report a rare case of NMS that occurred postoperatively in a tongue cancer patient whose surgery consisted of hemiglossectomy, neck dissection, and immediate reconstruction. 2. Case Report A 39-year-old man came to the Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, complaining of a painful mass of the tongue border. His medical, social, and family histories were unremarkable. The diagnosis was tongue cancer (T2N1£¿M0). He
%U http://www.hindawi.com/journals/crid/2013/542130/