Neuroleptic malignant syndrome in children.

OBJECTIVES

To report a case of neuroleptic malignant syndrome (NMS) in a child, and review reports of 11 other paediatric cases of NMS.

CLINICAL FEATURES: A 6-year-old child treated with thioridazine for behavioural disturbance developed NMS following an episode of dehydration. The clinical features of this case are compared to other reports of NMS in childhood, and in adults, where the disease is far more common, usually being precipitated by major tranquillisers.

INTERVENTION AND OUTCOME: The patient made a full recovery with supportive management. In adults the disease has a mortality of 15%-40%, and two of the previously reported paediatric cases have also been fatal. Treatment options, including dantrolene and antiparkinsonian agents are reviewed.

CONCLUSION

NMS is rare in childhood, but is usually precipitated by commonly prescribed drugs. There is a significant mortality associated with the condition, and early diagnosis and treatment are essential for a good outcome.