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The British Journal of Psychiatry 153: 107-111 (1988)
© 1988 The Royal College of Psychiatrists

Spectrum concept of neuroleptic malignant syndrome

Adityanjee, S Singh, G Singh and S Ong
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur.

Although neuroleptic malignant syndrome (NMS) was initially thought to be a rare, idiosyncratic complication, the incidence estimates have been rising over the years. A part of this increase can be explained on the basis of an over-inclusive definition of NMS. The unitary concept of NMS has been challenged recently and a spectrum concept has been enunciated on the basis of findings of retrospective chart-reviews which have used too broad a definition of NMS. The authors describe three cases of neuroleptic-related toxicity with different clinical presentations which appeared in a manner apparently supporting the spectrum concept. They discuss this controversial concept critically, however, and caution against its overzealous use in routine clinical practice owing to its far-reaching clinical implications.


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