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BMC Neurology

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Open Access 01-12-2022 | Schizophrenia | Case report

Muscle magnetic resonance imaging abnormality in neuroleptic malignant syndrome: a case report

Authors: Yuki Kakinuma, Ryota Amano, Atsushi Ishida, Ichizo Nishino, Katsumi Taki

Published in: BMC Neurology | Issue 1/2022

Abstract

Background

Neuroleptic malignant syndrome (NMS) is a rare and occasionally fatal undesirable reaction to dopamine antagonists, and its phenotype is diverse owing to causative drugs. Classically, elevation of serum creatine kinase is described in NMS. Some reports have described muscular pathological findings; however, muscle magnetic resonance imaging (MRI) has not been reported previously.

Case presentation

A 63-year-old woman with a history of schizophrenia presented to our hospital with a high fever, excessive sweating, muscle weakness, and elevated serum creatine kinase levels. Muscle MRI revealed T2 high-intensity lesions in several muscles with gadolinium enhancement, and the pathology of the muscle biopsy showed a very mild presence of muscle fiber necrosis and regeneration with type 2c fibers without inflammation. Her symptoms resolved by treatment with levodopa/carbidopa, dantrolene. Finally, the patient was diagnosed with NMS.

Conclusions

This is the first report of muscle MRI abnormalities in a patient with NMS. Muscle MRI abnormalities in NMS may be associated with non-inflammatory myopathic changes. The cause of creatine kinase elevation cannot be explained by abnormal strong muscle contraction nor inflammation.

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Title: Muscle magnetic resonance imaging abnormality in neuroleptic malignant syndrome: a case report
Authors: Yuki Kakinuma
Ryota Amano
Atsushi Ishida
Ichizo Nishino
Katsumi Taki
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Schizophrenia
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Pathology
Carbidopa
Levodopa
Dantrolene
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02937-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Muscle magnetic resonance imaging abnormality in neuroleptic malignant syndrome: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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