A review of neuroleptic malignant syndrome : incidence and features in Malta

Abstract

This paper describes Malta’s first sample of Neuroleptic Malignant Syndrome (NMS) and reviews the current literature. A retrospective sample of all diagnosed cases of NMS was reviewed using Pope’s (1986) criteria. Twelve cases were identified yielding an incidence of 0.67%. The range of associated risk factors and complications agreed with other reports. There were also two cases of uncontrolled diabetes. Treatments commonly used were Bromocriptine and Levodopa. There were no deaths due to NMS and no recurrence on re-exposure. The sample is too small to draw any statistically significant conclusions, however, the results are mostly in line with those obtained from larger samples. Malta’s incidence is towards the lower end of the reported range of 0.02% to 3.23%, but higher than that reported in centres trying to recognise NMS early and reduce risk factors. This suggests that Malta could benefit from trying to adopt such measures. Given Malta’s small size, it would be relatively easy to disseminate such information. This study, despite its comprehensive sample, failed to reveal any other reported cases. Nor has it been demonstrated that diabetics were at higher risk of developing NMS or its complications. It would be important to explore these possibilities further in future studies.