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A Neuroleptic malignant syndrome patient associated with COVID-19: Case report

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  1. Introduction:Various neurological manifestations associated with COVID-19 have been detected, and its incidence has been increasing. Neurological symptoms in COVID-19 patients have been determined by 36.4% and were common with severe infection. In literature, neuroleptic malignant syndrome relevant to patients with COVID-19 has been reported very few.
  2. Case:A 72-year-old man was admitted to our clinic with an altered mental status, speech disorder, occasionally urinary incontinence. His tremors, diaphoresis, tachycardia, and fever had been developed 3 days before admission. In the neurologic examination, the patient was disoriented and confused, and he had a lead pipe posture. The cerebral magnetic resonance imaging (MRI) and diffusion-weighted MRI was normal. The creatinine kinase (CK) was increased. The diagnosis of the neuroleptic malignant syndrome (NMS) has been confirmed based on DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), Nierenberg, and Levenson criteria. Non-enhanced chest computed tomography (CT) has shown the COVID-19 infiltration. COVID-19 test by PCR (Polymerase Chain Reaction) was positive in the nasopharyngeal swab. After bromocriptine and intravenous hydration treatment, his CK began to downtrend on day 3, and rigidity also improved.
  3. Conclusion:In our case first reported in Turkey, the neuroleptic malignant syndromer are in patients with COVID-19 has been determined. It aimed to raise awareness on this subject.


neuroleptic malignant syndrome, COVID-19, pandemic