ʻO ka maʻi neuroleptic malignant kahi maʻi i hōʻike ʻia e kahi maʻi ma ka pae neurological. ʻO kēia maʻi maʻi ka hopena o nā hopena ʻaoʻao i ka wā e lawe ai i nā lāʻau lapaʻau e like me nā neuroleptics a i ʻole anti-psychotics. (2)

Hoʻopili ʻia kēia maʻi maʻi i ke ʻano idiosyncratic, ʻo ia hoʻi ke ʻano o ke ʻano o kēlā me kēia kanaka, kāna mau hana a me kāna ʻano me kona kaiapuni.

Ke alakaʻi nei kēia pathology i nā fevers kiʻekiʻe, ka wela, ka instability ma ke ʻano o ke koko, rigidity muscle a me nā dysfunctions i nā automatisms.

I ka hapanui o nā hihia, ʻike ʻia nā hōʻailona mua ma hope o ʻelua pule o ka mālama ʻana me nā neuroleptics a i ʻole anti-psychotics. Eia naʻe, hiki ke ʻike ʻia nā hōʻailona pili i ka maʻi i ka wā o ka lawe ʻana i ka lāʻau lapaʻau.

ʻO nā hihia o ka maʻi neuroleptic malignant ua lawe ʻia i mua ma hope o ka mālama ʻana me nā lāʻau anti-Parkinson. (2)

ʻO ka ʻike wikiwiki o ka neuroleptic malignant syndrome i hoʻokumu ʻia e ka lawe ʻana i nā neuroleptics a i ʻole anti-psychotics e hiki ai ke hōʻemi i nā hopena pili.

Hoʻopilikia ka Neuroleptic malignant syndrome ma kahi o 1 a 2 mau hihia ma 10 mau maʻi e mālama ana i ka neuroleptic a i ʻole antipsychotic lapaʻau. Pili kēia maʻi i nā kāne a me nā wahine me ka hapa iki o nā kāne, o nā makahiki āpau. (000)

Hoʻopili ʻia ka maʻi maʻi neuroleptic me nā hiʻohiʻona like ʻole e like me: (1)

• pyrexia: loaʻa i ke kuni nui a i ʻole ke kūlana febrile mau;
• ʻiʻo hypertonia: hoʻonui i ka leo i loko o nā ʻiʻo;
• nā hoʻololi i nā kūlana noʻonoʻo;
• hemodynamic deregulation (deregulation in the blood circulation)

ʻO kahi hiʻohiʻona kikoʻī i ka neuroleptic malignant syndrome ʻo ia ka hele ʻana o ka rigidity muscular koʻikoʻi e pili ana me ka nele o nā reflexes: "lead-pipe" rigidity. (1)

ʻIke ʻia nā hiʻohiʻona e pili ana i nā hōʻailona koʻikoʻi i kēia ʻano o ka pathology: (4)

• hypertension;
• tachycardia (ka puʻuwai wikiwiki);
• tachypnea (ka hanu wikiwiki);
• hyperthermia (> 40 °), ma muli o ka loaʻa ʻana o ke kuni ikaika;
• hypersalivation;
• acidosis (acidification o ke koko me ka pH koko ma lalo o kona pae maʻamau ma waena o 7.38 a me 7.42.);
• kāohi ʻole.

ʻIke ʻia nā hoʻololi i nā ʻāpana olaola i kēia ʻano maʻi: (4)

• kahi kiʻekiʻe o ka serum phosphokinases a me nā transaminase;
• rhabdomyolysis (ka luku ʻana i ka ʻiʻo ʻiʻo i loko o nā ʻiʻo striated).

ʻO ka ulu ʻana o ka maʻi maʻi neuroleptic mai nā hopena ʻaoʻao e pili ana i ka lawe ʻana i nā lāʻau lapaʻau o nā ʻano: neuroleptics a me anti-psychotics.

ʻO ke kumu koʻikoʻi koʻikoʻi i ka hoʻomohala ʻana o ka neuroleptic malignant syndrome ʻo ia ka hoʻohana ʻana i nā neuroleptics a i ʻole anti-psychotics. (4)

Eia kekahi, ʻo ka luhi kino, hoʻomaha ʻole, dehydration kekahi mau mea hou e pili ana i ka pilikia o ka hoʻomohala ʻana i ka maʻi.

ʻO ka poʻe maʻi e lawe ana i nā neuroleptics a i ʻole anti-psychotics ma nā kiʻekiʻe kiʻekiʻe, ma ke ʻano parenteral (ka hoʻokele ʻana o ka lāʻau lapaʻau e ka intravenous, intramuscular route, etc.) a i ʻole me ka piʻi wikiwiki ʻana o ka dosage i ʻoi aku ka nui o ka hoʻomohala ʻana i ka pathology. (4)

Hoʻomaʻamaʻa pinepine ʻia ka mālama ʻana no kēia maʻi.

Hoʻopau ʻia ka lāʻau e hoʻoulu ai i ka maʻi (neuroleptic a i ʻole antipsychotic) a mālama nui ʻia ke kuni.

Hiki ke kuhikuhi ʻia nā lāʻau e hoʻomaha ai i ka ʻiʻo. Eia kekahi, hoʻohana pinepine ʻia nā lāʻau lapaʻau dopamine (dopaminergic drugs) i ka mālama ʻana i kēia pathology. (2)

I kēia lā, ʻaʻohe lāʻau lapaʻau kūikawā no kēia maʻi maʻi i ke kumuhana o nā hōʻike paʻa.

Eia nō naʻe, ua hōʻike ʻia nā pono o ka mālama ʻana me benzodiazepines, dopaminergic agents (bromocriptine, amantadine), dantrolenes (muscle relaxants) a me ka electroconvulsive therapy.

Pono ka nānā pono ʻana i nā poʻe maʻi me ka hāʻule ʻole o ka cardio-respiratory, ka hemahema o ka renal, aspiration pneumonia a me ka coagulopathy.

Eia kekahi, hiki ke kuhikuhi ʻia ke kōkua hanu a me ka dialysis.

I ka hapanui o nā hihia, hiki i nā maʻi me ka neuroleptic malignant syndrome ke hoʻōla piha. Eia nō naʻe, hoʻomau nā hōʻailona amnesic, extrapyramidal (me nā maʻi neurological), nā maʻi lolo, peripheral neuropathy, myopathy a me nā contractures i kekahi mau hihia. (4)

I ka loaʻa ʻole o ka lāʻau lapaʻau a ma hope o ka hoʻōki ʻana i ka lāʻau psychotropic e kumu ai ka maʻi, hoʻōla maʻamau ka maʻi neuroleptic malignant ma waena o 1 a me 2 mau pule.

Eia kekahi, hiki i ka maʻi ke make.

ʻO nā kumu o ka make i loko o ka pōʻaiapili o kēia maʻi ʻo ia ka hopu ʻana i ka cardiopulmonary, aspiration pneumonia (ke komo ʻana o ka pulmonary i hōʻike ʻia e ka reflux o ka wai i loko o ka bronchi mai ka ʻōpū), pulmonary embolism, myoglobinuric renal failure (renal failure me ke komo ʻana o ke koko i loko o ka mimi). , a i ʻole ka hoʻolaha ʻana o ka coagulation intravascular. (4)

ʻO ka nui o ka make e pili ana i kēia pathology ma waena o 20 a 30%.