A case of neuroleptic malignant syndrome associated with reversible leukoencephalopathy

• Published in: Rinshō shinkeigaku Vol. 39; no. 11; p. 1147
• Main Authors: Sugimoto, T, Tsunoda, S, Shindou, K, Shiozawa, Z
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.11.1999
• Subjects: Adrenal Cortex Hormones - therapeutic use; Antipsychotic Agents - adverse effects; Female; Glycerol - therapeutic use; Haloperidol - adverse effects; Humans; Leukoencephalopathy, Progressive Multifocal - chemically induced; Leukoencephalopathy, Progressive Multifocal - diagnosis; Leukoencephalopathy, Progressive Multifocal - drug therapy; Magnetic Resonance Imaging; Middle Aged; Neuroleptic Malignant Syndrome - diagnosis; Neuroleptic Malignant Syndrome - drug therapy; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0009-918X

We report a case of neuroleptic malignant syndrome associated with reversible leukoencephalopathy. The patient was a 60-year-old woman. Soon after ingesting an antipsychotic drug, the patient developed neuroleptic symptoms. After hydration and dantrolene sodium were administered, muscular rigidity gradually improved and serum levels of CK became normal. On the 7th hospital day, however, she fell into coma and showed tetraplegia. Although brain CT was normal on admission, diffuse low density areas were observed on the parieto-occipital cerebral white matter. The same lesions were observed on T2-weighted MRI. On the 20th hospital day, after giving her glycerol and adrenocorticosteroid, not only abnormal neurological findings but also abnormal CT and MRI findings disappeared. There were only two case reports of leukoencephalopathy with malignant syndrome in the literature. This is a rare case of reversible leukoencephalopathy with neuroleptic malignant syndrome due to the antipsychotic drug.