Template:AMS and fever DDX: Difference between revisions

Revision as of 16:39, 22 December 2015

Sepsis
Neuroleptic malignant syndrome - Serotonin Syndrome(SS) vs Neuroleptic Malignant Syndrome(NMS)
- Differentiation between the SS and NMS can be challenging. History of a new serotonergic drug or a dose increase of a serotonergic drug are helpful. SS is usually much more acute in onset than NMS which may develop over days or weeks. On physical exam the presence of ‘lead pipe’ rigidity is typical of NMS, while patients with SS manifest tremor and hyperreflexia.
- Elevations in creatine kinase, liver function tests (lactate dehydrogenase, aspartate transaminase), and white blood cell count, coupled with a low serum iron level, distinguishes NMS from SS among patients taking neuroleptic and serotonin agonist medications simultaneously.
Serotonin syndrome
Malignant hyperthermia
Sympathomimetic toxicity (cocaine, amphetamine, ketamine)
Anticholinergic toxicity
Meningitis
Encephalitis
Heat stroke
Delirium tremens
Hypothalamic stroke
Pheochromocytoma
Thyroid storm

@@ Line 1: / Line 1: @@
 ===[[Altered mental status]] and fever===
 *[[Sepsis]]
-*[[Neuroleptic malignant syndrome]]
+*[[Neuroleptic malignant syndrome]] - Serotonin Syndrome(SS) vs Neuroleptic Malignant Syndrome(NMS)
+**Differentiation between the SS and NMS can be challenging. History of a new serotonergic drug or a dose increase of a serotonergic drug are helpful. SS is usually much more acute in onset than NMS which may develop over days or weeks. On physical exam the presence of ‘lead pipe’ rigidity is typical of NMS, while patients with SS manifest tremor and hyperreflexia.
+**Elevations in creatine kinase, liver function tests (lactate dehydrogenase, aspartate transaminase), and white blood cell count, coupled with a low serum iron level, distinguishes NMS from SS among patients taking neuroleptic and serotonin agonist medications simultaneously.
 *[[Serotonin syndrome]]
 *[[Malignant hyperthermia]]