The neuroleptic malignant syndrome: occurrence in a 15-year-old boy and recovery with bromocriptine therapy.

The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to neuroleptic medication not previously described in the pediatric literature. It is characterized by hyperthermia, extrapyramidal disorders, decreased level of consciousness and autonomic dysfunction. A 15-year-old boy with acute lymphoblastic leukemia developed the NMS after a brief exposure to chlorpromazine and promethazine. He responded favorably to the dopamine agonist bromocriptine. A review of the recent literature suggests bromocriptine as the most efficacious specific therapy. Management of the NMS includes immediate discontinuation of all neuroleptic agents, intense supportive care and prompt institution of bromocriptine therapy.