A RARE CASE OF NEUROLEPTIC MALIGNANT SYNDROME WITH LITHIUM ENCEPHALOPATHY

Volume : VII, Issue : X, October - 2018

Dr. Nilima K. Shah, Dr. Parth Patel, Dr. Dushyant Patel, Dr. Saurabh Daseda

A rare case presentation of 50 year old male patient with neuroleptic malignant syndrome(NMS) & lithium encephalopathy

simultaneously .Antipsychotics like trifluoperazine are used in mania but it can cause neuroleptic malignant syndrome. lithium is

used in treatment of bipolar mood disorders extensively but it can cause CNS toxicity and consequent encephalopathy and renal

failure.NMS is an idiosyncratic reaction to antipsychotics.The underlying pathopysioloic mechanism can be explained by marked

and sudden reduction in central dopaminergic activity resulting fromD2 dopaminergic receptor blockade within

nigrostriatal,hypothalamic,limbic/cortical pathways on the basis of clinical features of NMS.Lithium has narrow therapeutic

index(0.5 to 1.2 meq/l).Overdose symtoms are regularly seen at concentration above 1.5 meq/L.The identified risk factors for

lithium toxicity includes age>50 years,subnormal endogenous creatinine clearance and thyroid dysfunction.