A Fatal Case of Neuroleptic Malignant Syndrome After Paralytic Bowel in a Patient Taking Antiparkinson Medication

OBJECTIVES: We report a fatal case of neuroleptic malignant-like syndrome, which occurred as a consequence of paralytic bowel in a 72-year-old woman on treatment with antiparkinson medication. CASE DESCRIPTION: Contrast enhanced computerized tomography of the chest and abdomen demonstrated the presence of paralytic bowel. RESULTS: The patient died. CONCLUSIONS: Physicians involved in the treatment of patients affected by Parkinson’s disease should take into consideration the possibility of dopaminergic drug malabsorption due to paralytic bowel as a possible cause of neuroleptic malignant-like syndrome. LEARNING POINTS: Clinical features of neuroleptic malignant-like syndrome (NMLS) in parkinsonian patients are similar to those of neuroleptic malignant syndrome (NMS), which is a potentially fatal condition associated with the withdrawal of antipsychotic medication. Paralytic bowel is a condition frequently impairing medication absorption in the absence of modifications to the normal daily intake of antiparkinson drugs. The present case report describes the fatal outcome of NMLS following paralytic bowel in a parkinsonian patient on levodopa and amantadine therapy.