甲氯帕胺治疗后持续高热;抗精神病药恶性综合征

IF 0.1 Q4 EMERGENCY MEDICINE Journal of Emergency Medicine Case Reports Pub Date : 2022-08-03 DOI:10.33706/jemcr.1112956
C. Sezer, F. Tekin
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引用次数: 0

摘要

简介:抗精神病药恶性综合征(NMS)是一种神经递质水平在服用抗精神病药后出现波动的状态。NMS病因尚不清楚。这是一种神经系统急症包括精神状态改变,僵硬,发烧和自主障碍等症状。我们在这里的目的是提到甲氧氯普胺的副作用,它通常用于急诊科(ED)。在我们的病例中,在静脉注射甲氧氯普胺后,患者临床症状恶化,出现NMS症状,这对急诊科医生来说是非常意外和不希望的。通过本病例报告,希望提高对甲氧氯普胺和NMS的副作用的认识。病例报告:21岁男性,无慢性疾病史,经静脉单剂量甲氧氯普胺缓解腹痛后,迅速出现发热、肌肉僵硬、精神错乱、血压波动等症状,伴白细胞增多、肌酸激酶升高。医生怀疑是NMS。进一步的实验室和影像学检查排除了其他中枢神经系统病变和感染。经对症治疗,患者临床好转,出院痊愈。结论:甲氧氯普胺引起的NMS非常罕见,但包括甲氧氯普胺在内的治疗方法在急症中的应用非常普遍。服用该药后,如果患者临床状态恶化,出现发热、意识不清、肌肉僵硬等症状,医生应牢记NMS。
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Persistent High Fever After Metchloropramide Treatment; Neuroleptic Malignant Syndrome
Introduction: Neuroleptic Malignant Syndrome(NMS) is a state neurotransmitter levels fluctuate subsequent to administration of neuroleptic agents. Etiology of NMS is unclear. It’s a neurological emergency includes symptoms like altered mental status, rigidity, fever and dysautonomy. Our aim in here is to mention the side effects of metochlopramide, which is commonly used in Emergency Departments(ED). In our case, subsequent to intravenous admission of metochlopramide, patients clinic worsened with NMS symptoms and this was quite unexpected and unwanted for ED doctors. By this case report it is wanted to raise awareness against, side effects of metoclopramide and NMS. Case Report: Subsequent to intravenous administration of single dose metoclopramide to relieve abdominal pain into 21 years old male with no history of chronical diseases, symptoms of fever, muscle rigidity, confusion and fluctuating blood pressure levels quickly emerged along with leukocytosis and high levels of Creatine Kinase. ED Doctors suspected NMS. Futher laboratory and imaging stuides has excluded other central nervous system pathologies and infections. Eventually, patients clinic got better with symptomatic theraphy and he was discharged fully recovered. Conclusion: NMS due to metoclopramide is quite rare, but usage of therapies includes Metoclopramid at ED’s are quite often. Subsequent to administration of this drug, if patients clinical state worsens with fever, confusion and muscle rigidity, phycisians should keep NMS in mind.
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