Neuroleptic malignant syndrome in children and adolescents.

OBJECTIVE Neuroleptic malignant syndrome (NMS) is a serious iatrogenic condition. This report reviews the world literature to characterize the syndrome and evaluate factors that promote early detection and effective intervention. METHOD The review identified 77 NMS cases (49 males, 27 females, 1 gender unknown); ages ranged from 0.9 to 18 years (mean 14.8 +/- 3.96). Univariate and multiple regression analyses were applied to 38 variables to identify early signs of the disorder, to identify correlates of outcome, and to evaluate treatments. RESULTS The duration of NMS spanned from 1 to 119 days. Nine percent of patients died and 20% resolved with serious sequelae. Patients receiving low-potency neuroleptics had a poorer outcome (p = .01). Fever was related to longer duration of illness (p = .03). Anticholinergics and bromocriptine were effective and without fatalities, but dantrolene was not useful in this sample of children and adolescents. CONCLUSIONS Early detection and appropriate interventions appear important in moderating the course and outcome of NMS.