Neuroleptic malignant Syndrome yog ib yam kab mob uas tshwm sim los ntawm cov kab mob ntawm lub paj hlwb. Cov tsos mob no feem ntau tshwm sim los ntawm cov kev mob tshwm sim thaum noj tshuaj xws li neuroleptics lossis anti-psychotics. (2)

Cov tsos mob no tau txuas nrog lub xeev idiosyncratic, uas yog hais txog kev ua ntawm txhua tus neeg, nws cov kev xav thiab nws tus cwj pwm nrog nws ib puag ncig.

Qhov no pathology ua rau kub taub hau, tawm hws, instability ntawm cov ntshav siab, cov leeg rigidity thiab dysfunctions nyob rau hauv lub automatisms.

Nyob rau hauv feem ntau ntawm cov mob, thawj cov tsos mob tshwm sim tom qab ob lub lis piam ntawm kev kho mob nrog neuroleptics los yog anti-psychotics. Txawm li cas los xij, cov tsos mob cuam tshuam nrog tus kab mob tuaj yeem tshwm sim thoob plaws lub sijhawm noj tshuaj.

Cov teeb meem ntawm neuroleptic malignant syndrome kuj tau coj mus rau ua ntej tom qab kev kho mob tsis tu ncua nrog tshuaj tiv thaiv Parkinson. (2)

Kev kuaj mob sai sai ntawm neuroleptic malignant syndrome tshwm sim los ntawm kev noj cov tshuaj neuroleptics lossis tshuaj tiv thaiv kev puas siab puas ntsws ua rau nws tuaj yeem txo qhov cuam tshuam.

Neuroleptic malignant syndrome cuam tshuam txog li 1 mus rau 2 tus neeg mob hauv 10 tus neeg mob uas tau txais kev kho mob neuroleptic lossis antipsychotic. Qhov kev nthuav dav no cuam tshuam rau txiv neej thiab poj niam nrog me ntsis predominance rau txiv neej, ntawm txhua lub hnub nyoog. (000)

Neuroleptic malignant syndrome yog txuam nrog ntau yam kev kho mob xws li: (1)

• pyrexia: muaj kub taub hau los yog lub xeev febrile mus tas li;
• nqaij hypertonia: nce suab nrov hauv cov leeg;
• kev hloov hauv kev puas siab puas ntsws;
• hemodynamic deregulation (deregulation nyob rau hauv cov ntshav ncig)

Ib tug yam ntxwv tshwj xeeb rau neuroleptic malignant syndrome yog lub xub ntiag ntawm cov nqaij ntshiv rigidity tseem ceeb uas cuam tshuam nrog qhov tsis muaj reflexes: "cov yeeb nkab" rigidity. (1)

Cov yam ntxwv ntawm cov cim tseem ceeb kuj pom tau hauv hom kab mob no: (4)

• ntshav siab;
• tachycardia (lub plawv dhia ceev);
• tachypnea (ua pa nrawm);
• hyperthermia (> 40 °), tshwm sim los ntawm qhov muaj kub taub hau;
• hypersalivation;
• acidosis (acidification ntawm cov ntshav nrog cov ntshav pH qis dua nws cov qib ib txwm nyob nruab nrab ntawm 7.38 thiab 7.42.);
• tus kheej.

Kev hloov pauv hauv cov kab mob lom neeg kuj pom nyob rau hauv hom kab mob no: (4)

• qib siab ntawm cov ntshav phosphokinases thiab transaminases;
• rhabdomyolysis (kev puas tsuaj ntawm cov leeg nqaij hauv cov leeg nqaij striated).

Kev loj hlob ntawm neuroleptic malignant syndrome tshwm sim los ntawm cov kev mob tshwm sim cuam tshuam nrog kev noj tshuaj ntawm hom: neuroleptics thiab tshuaj tiv thaiv kev puas siab puas ntsws.

Qhov tseem ceeb tshaj plaws ntawm kev pheej hmoo ntawm kev loj hlob ntawm neuroleptic malignant syndrome yog kev siv cov neuroleptics los yog kev tiv thaiv kev puas siab puas ntsws. (4)

Tsis tas li ntawd, lub cev qaug zog, tsis xis nyob, lub cev qhuav dej yog qhov tseem ceeb ntawm kev pheej hmoo ntawm kev tsim tus kab mob.

Cov neeg mob noj cov tshuaj neuroleptics lossis tshuaj tiv thaiv kev puas siab puas ntsws ntawm cov koob tshuaj ntau, hauv daim ntawv parenteral (kev tswj hwm cov tshuaj los ntawm txoj hlab ntshav, intramuscular txoj kev, thiab lwm yam) lossis nrog kev nce ntxiv ntawm cov koob tshuaj muaj peev xwm loj dua ntawm kev tsim cov kab mob. (4)

Kev kho mob rau tus mob no feem ntau yog mob hnyav.

Cov tshuaj ua rau muaj mob (neuroleptic lossis antipsychotic) raug tso tseg thiab kub taub hau tau kho mob hnyav.

Cov tshuaj uas tso cai rau cov leeg nqaij so tuaj yeem raug sau tseg. Tsis tas li ntawd, kev kho mob raws li dopamine (cov tshuaj dopaminergic) feem ntau muaj txiaj ntsig zoo hauv kev kho mob ntawm cov kab mob no. (2)

Txog rau tam sim no, tsis muaj kev kho tshwj xeeb rau tus mob no tau ua pov thawj pom tseeb.

Txawm li cas los xij, cov txiaj ntsig ntawm kev kho mob nrog benzodiazepines, dopaminergic agents (bromocriptine, amantadine), dantrolenes (muscle relaxants) thiab electroconvulsive therapy tau raug tshaj tawm.

Kev saib xyuas kom zoo yog tsim nyog nyob rau hauv cov neeg mob uas muaj cardio-respiratory tsis ua hauj lwm, lub raum tsis ua hauj lwm, aspiration pneumonia thiab coagulopathy.

Tsis tas li ntawd, kev pab ua pa thiab lim ntshav tuaj yeem raug sau tseg.

Feem ntau, cov neeg mob neuroleptic malignant syndrome ua kom rov zoo tag nrho. Txawm li cas los xij, cov tsos mob amnesic, extrapyramidal (ua ke nrog cov kab mob hauv lub paj hlwb), mob hlwb, peripheral neuropathy, myopathy thiab contractures tuaj yeem tshwm sim hauv qee kis. (4)

Thaum tsis muaj kev kho mob thiab tom qab tso tseg cov tshuaj psychotropic uas ua rau tus kab mob, neuroleptic malignant syndrome feem ntau kho tau ntawm 1 thiab 2 lub lis piam.

Tsis tas li ntawd, tus kab mob no tuaj yeem ua rau tuag taus.

Cov ua rau tuag nyob rau hauv cov ntsiab lus ntawm tus kab mob no yog cardiopulmonary ntes, aspiration pneumonia (pulmonary kev koom tes uas yog yus muaj los ntawm reflux ntawm cov kua rau hauv lub bronchi ntawm lub plab), pulmonary embolism, myoglobinuric raum tsis ua hauj lwm (lub raum tsis ua hauj lwm nrog cov ntshav nyob rau hauv cov zis). los yog disseminated intravascular coagulation. (4)

Qhov kev tuag ntawm cov kab mob no yog nyob nruab nrab ntawm 20 thiab 30%.