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Neuroleptic malignant syndrome — ACEM Fellowship MCQ

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HardPsychiatric emergenciesNeuroleptic malignant syndromeACEM Fellowship

A 37-year-old man from an inpatient mental health unit presents to a Sydney ED, triage category 1, with fever and rigidity after recent haloperidol dose increase. Temp 40.2 C, HR 132, BP labile. CK is 12,500 U/L and WCC is 19. What is the most likely diagnosis?

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Correct answer: E — Neuroleptic malignant syndrome

Fever, lead-pipe rigidity, autonomic instability and high CK after antipsychotic escalation indicate NMS.

Reference: eTG toxicology; ACEM psychiatric emergency curriculum