Hyperthermia and neurological catastrophe: An interesting case report

Fever is a common symptom encountered in clinical practice. Hyperthermia, though infrequently encountered, can be genetical (malignant hyperthermia) or acquired when the body temperature rises beyond a certain set point that is controlled by the hypothalamus. We report a case of an elderly male who reported to us with hyperthermia, accelerated hypertension, and brain haemorrhage (as a sequelae of uncontrolled hypertension). A thorough clinical history pointed towards neuroleptic malignant syndrome (NMS). A remarkable response was observed with dantrolene and bromocriptine along with the discontinuation of the offending drug. With conservative management, the patient had complete recovery. This case highlights the importance of even sub-therapeutic drug dosage, particularly neuropsychiatric drugs, in the development of neurological catastrophe.