I-Neuroleptic malignant syndrome yi-pathology ebonakala ngesifo ezingeni le-neurological. Lesi sifo ngokuvamile siwumphumela wemiphumela engemihle lapho uthatha izidakamizwa ezifana ne-neuroleptics noma i-anti-psychotics. (2)

Lesi sifo sixhunyaniswa nesimo se-idiosyncratic, okusho indlela yokuba umuntu ngamunye, ukusabela kwakhe nokuziphatha kwakhe ngendawo yakhe.

Le pathology iholela emazingeni aphezulu, ukujuluka, ukungazinzi mayelana nomfutho wegazi, ukuqina kwemisipha kanye nokungasebenzi kahle kwe-automatisms.

Ezimweni eziningi, izimpawu zokuqala zivela ngemva kwamasonto amabili okwelashwa nge-neuroleptics noma anti-psychotics. Kodwa-ke, izimpawu ezihambisana nalesi sifo zingase zivele phakathi nenkathi yokuphuza imithi.

Amacala e-neuroleptic malignant syndrome aphinde alethwa phambili kulandela ukunqanyulwa kokwelashwa ngezidakamizwa ezilwa noParkinson. (2)

Ukuxilongwa okusheshayo kwe-neuroleptic malignant syndrome okubangelwa ukuthatha ama-neuroleptics noma ama-anti-psychotics kwenza kube nokwenzeka ukunciphisa imiphumela ehambisanayo.

I-Neuroleptic malignant syndrome ithinta cishe izimo ezi-1 kuya kwezi-2 ezigulini eziyi-10 ezithola ukwelashwa kwe-neuroleptic noma i-antipsychotic. Lokhu kubhebhetheka kuthinta abesilisa nabesifazane ngokudlanzana okuncane kwabesilisa, babo bonke ubudala. (000)

I-Neuroleptic malignant syndrome ihlotshaniswa nezici ezihlukahlukene zomtholampilo ezifana nalezi: (1)

• i-pyrexia: ukuba khona kwemfiva enamandla noma isimo se-febrile unomphela;
• i-muscle hypertonia: ithoni ekhulayo emisipha;
• izinguquko ezimweni zengqondo;
• i-hemodynamic deregulation (ukwehliswa kokujikeleza kwegazi)

Isici esiqondene ngqo ne-neuroleptic malignant syndrome ukuba khona kokuqina kwemisipha okuphawulekayo okuhlobene nokungabikho kokukhalipha: ukuqina "kwepayipi lomthofu". (1)

Izimpawu ngokwezimpawu ezibalulekile nazo ziyabonakala kulolu hlobo lwe-pathology: (4)

• umfutho wegazi ophakeme;
• tachycardia (ukushaya kwenhliziyo okusheshayo);
• tachypnea (ukuphefumula ngokushesha);
• i-hyperthermia (> 40 °), okubangelwa ukuba khona kwemfiva enamandla;
• hypersalivation;
• i-acidosis (i-acidification yegazi ene-pH yegazi ephansi kunezinga layo elivamile eliphakathi kuka-7.38 no-7.42.);
• ukungakwazi ukuzithiba.

Izinguquko kumingcele yezinto eziphilayo nazo ziyabonakala kulolu hlobo lwesifo: (4)

• izinga eliphezulu le-serum phosphokinase kanye ne-transaminase;
• i-rhabdomyolysis (ukubhujiswa kwezicubu zemisipha ngaphakathi kwemisipha e-striated).

Ukuthuthukiswa kwe-neuroleptic malignant syndrome kuvela emiphumeleni emibi ehambisana nokuthatha izidakamizwa zezinhlobo: i-neuroleptics kanye ne-anti-psychotics.

Isici esibaluleke kakhulu engozini ekuthuthukisweni kwe-neuroleptic malignant syndrome ukusetshenziswa kwe-neuroleptics noma i-anti-psychotics. (4)

Ngaphezu kwalokho, ukukhathala ngokomzimba, ukuphumula, ukuphelelwa amandla kwamanzi yizici ezengeziwe mayelana nengozi yokuthuthukisa lesi sifo.

Iziguli ezithatha ama-neuroleptics noma ama-anti-psychotics ngemithamo ephezulu, ngendlela yomzali (ukuphathwa komuthi ngomzila we-intravenous, intramuscular, njll.) noma ngokukhuphuka ngokushesha komthamo kunengozi enkulu yokuthuthukisa i-pathology. (4)

Ukwelashwa kwalesi syndrome ngokuvamile kunamandla.

Umuthi obangela ukugula (i-neuroleptic noma i-antipsychotic) uyamiswa futhi umkhuhlane welashwa kakhulu.

Imithi evumela ukuphumuza imisipha ingase inqunywe. Ngaphezu kwalokho, ukwelashwa okusekelwe ku-dopamine (izidakamizwa ze-dopaminergic) ngokuvamile ziwusizo ekwelapheni le pathology. (2)

Kuze kube manje, akukho ukwelashwa okuqondile kwalesi syndrome okuye kwaba yisihloko sobufakazi obuphathekayo.

Noma kunjalo, izinzuzo zokwelashwa ngama-benzodiazepines, ama-dopaminergic agents (i-bromocriptine, i-amantadine), ama-dantrolenes (iziphumlisi zemisipha) nokwelashwa kwe-electroconvulsive kuye kwabikwa.

Ukuqapha ngokucophelela kuyadingeka ezigulini ezinokwehluleka kwenhliziyo nokuphefumula, ukwehluleka kwezinso, i-aspiration pneumonia kanye ne-coagulopathy.

Ngaphezu kwalokho, kungase kubekwe usizo lokuphefumula kanye ne-dialysis.

Ezimweni eziningi, iziguli ezine-neuroleptic malignant syndrome zilulama ngokugcwele. Kodwa-ke, izimpawu ze-amnesic, i-extrapyramidal (kanye nokuphazamiseka kwemizwa), ukuphazamiseka kwengqondo, i-peripheral neuropathy, myopathy kanye nenkontileka kungase kuqhubeke kwezinye izimo. (4)

Uma kungekho ukwelashwa futhi ngemva kokumisa isidakamizwa se-psychotropic esibangela lesi sifo, i-neuroleptic malignant syndrome ngokuvamile yelashwa phakathi kweviki elingu-1 no-2.

Ngaphezu kwalokho, i-syndrome ingase ibulale.

Izimbangela zokufa kumongo walesi sifo ukuboshwa kwe-cardiopulmonary, i-aspiration pneumonia (ukubandakanyeka kwamaphaphu okubonakala nge-reflux yoketshezi ku-bronchi kusuka esiswini), i-pulmonary embolism, ukwehluleka kwe-myoglobinuric renal (ukwehluleka kwezinso ngokuba khona kwegazi emchameni) , noma ukusatshalaliswa kwe-intravascular coagulation. (4)

Izinga lokufa elihlobene nalesi sifo liphakathi kwama-20 nama-30%.