Author/Authors :
Lee, Jae Meen Department of Neurosurgery - Seoul National University Hospital - Seoul, Korea , Paek, Sun Ha Department of Neurosurgery - Seoul National University Hospital - Seoul, Korea , Park, Hye Ran Department of Neurosurgery - Seoul National University Hospital - Seoul, Korea , Lee, Kang Hee Department of Anesthesiology - Seoul National University Hospital - Seoul, Korea , Shin, Chae Won Department of Neurology - Seoul National University Hospital - Seoul, Korea , Park, Hye Young Department of Neurology - Seoul National University Hospital - Seoul, Korea , Park, Hee Pyoung Department of Anesthesiology - Seoul National University Hospital - Seoul, Korea , Kim, Dong Gyu Department of Neurosurgery - Seoul National University Hospital - Seoul, Korea , Jeon, Beom Seok Department of Anesthesiology - Seoul National University Hospital - Seoul, Korea
Abstract :
Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction
of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS) surgery in a cerebral palsy (CP)
patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory
dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored
anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity,
and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired,
despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after
DBS surgery, irrespective of continued dopaminergic medication.
