Neuroleptic malignant syndrome ndi matenda omwe amadziwika ndi matenda pamitsempha. Matendawa nthawi zambiri amakhala chifukwa cha zotsatira zoyipa mukamagwiritsa ntchito mankhwala monga neuroleptics kapena antipsychotics. (2)

Matendawa amalumikizidwa ndi kusakhazikika, ndiko kutanthauza momwe munthu aliyense amakhalira, momwe amachitira komanso momwe amachitira ndi chilengedwe chake.

Matendawa amabweretsa kutentha thupi kwambiri, thukuta, kusakhazikika kwa kuthamanga kwa magazi, kulimba kwa minofu ndi kusagwira ntchito mu automatisms.

Nthawi zambiri, zizindikiro zoyamba zimawonekera pakatha milungu iwiri yamankhwala ndi neuroleptics kapena antipsychotics. Komabe, zizindikiro zokhudzana ndi matendawa zingawonekere nthawi yonse ya kumwa mankhwala.

Milandu ya neuroleptic malignant syndrome idawonekeranso pambuyo posiya kulandira chithandizo ndi mankhwala odana ndi Parkinson. (2)

Kuzindikira mwachangu kwa neuroleptic malignant syndrome chifukwa chotenga ma neuroleptics kapena anti-psychotics kumapangitsa kuti athe kuchepetsa zotsatira zake.

Neuroleptic malignant syndrome imakhudza pafupifupi 1 mpaka 2 mwa odwala 10 omwe akudwala matenda a neuroleptic kapena antipsychotic. Kufalikira uku kumakhudza amuna ndi akazi omwe ali ndi chidwi chochepa kwa amuna, azaka zonse. (000)

Neuroleptic malignant syndrome imalumikizidwa ndi zinthu zosiyanasiyana zamankhwala monga: (1)

• pyrexia: kukhalapo kwa kutentha thupi kwambiri kapena kutentha thupi kosatha;
• hypertonia ya minofu: kuchuluka kwa mawu mu minofu;
• kusintha kwa maganizo;
• hemodynamic deregulation (kuchepa kwa kayendedwe ka magazi)

Chodziwika bwino cha neuroleptic malignant syndrome ndi kukhalapo kwa kulimba kwa minofu komwe kumalumikizidwa ndi kusakhalapo kwa ma reflexes: kulimba kwa "lead-pipe". (1)

Makhalidwe okhudzana ndi zizindikiro zofunikira amawonekeranso mumtundu uwu wa matenda: (4)

• matenda oopsa;
• tachycardia (kugunda kwa mtima mwachangu);
• tachypnea (kupuma mofulumira);
• hyperthermia (> 40 °), chifukwa cha kukhalapo kwa malungo aakulu;
• hypersalivation;
• acidosis (acidification ya magazi ndi pH ya magazi yotsika kuposa mlingo wake wabwinobwino womwe uli pakati pa 7.38 ndi 7.42.);
• kusadziletsa.

Kusintha kwa magawo achilengedwe kumawonekeranso mumtunduwu wa matenda: (4)

• kuchuluka kwa seramu phosphokinase ndi transaminases;
• rhabdomyolysis (kuwonongeka kwa minofu ya minofu mkati mwa minyewa yozungulira).

Kukula kwa neuroleptic malignant syndrome kumachokera ku zotsatira zoyipa zomwe zimagwirizanitsidwa ndi kumwa mankhwala amitundu: neuroleptics ndi antipsychotics.

Chofunikira kwambiri pachiwopsezo pakukula kwa neuroleptic malignant syndrome ndikugwiritsa ntchito ma neuroleptics kapena antipsychotics. (4)

Kuonjezera apo, kutopa kwa thupi, kusakhazikika, kutaya madzi m'thupi ndi zinthu zina zowonjezera pa chiopsezo chotenga matendawa.

Odwala omwe amatenga ma neuroleptics kapena anti-psychotics pamilingo yayikulu, mu mawonekedwe a parenteral (makonzedwe a mankhwalawa ndi intravenous, intramuscular njira, etc.) kapena akuwonjezeka mwachangu mulingo ali pachiwopsezo chachikulu chokhala ndi matendawa. (4)

Chithandizo cha matendawa nthawi zambiri chimakhala champhamvu.

Mankhwala oyambitsa matenda (neuroleptic kapena antipsychotic) amayimitsidwa ndipo kutentha thupi kumathandizidwa mwamphamvu.

Mankhwala olola kumasuka kwa minofu akhoza kuperekedwa. Kuphatikiza apo, mankhwala opangidwa ndi dopamine (mankhwala osokoneza bongo) nthawi zambiri amakhala othandiza pochiza matendawa. (2)

Mpaka pano, palibe chithandizo chapadera cha matendawa chomwe chakhalapo pa umboni weniweni.

Komabe, phindu la chithandizo cha benzodiazepines, dopaminergic agents (bromocriptine, amantadine), dantrolenes (zotsitsimutsa minofu) ndi electroconvulsive therapy zanenedwa.

Kuwunika mosamala ndikofunikira kwa odwala omwe ali ndi vuto la mtima-kupuma, kulephera kwa aimpso, chibayo chofuna kupuma komanso coagulopathy.

Kuphatikiza apo, chithandizo cha kupuma ndi dialysis chikhoza kuperekedwa.

Nthawi zambiri, odwala neuroleptic zilonda matenda kuchira kwathunthu. Komabe, zizindikiro za amnesic, extrapyramidal (pamodzi ndi vuto la minyewa), kusokonezeka kwaubongo, zotumphukira zamitsempha, myopathy ndi contracture nthawi zina zimatha. (4)

Ngati palibe chithandizo komanso mutasiya mankhwala a psychotropic omwe amayambitsa matendawa, matenda a neuroleptic malignant nthawi zambiri amachiritsidwa pakati pa 1 ndi 2 milungu.

Kuphatikiza apo, matendawa amatha kupha.

Zomwe zimayambitsa imfa pazochitika za matendawa ndi kumangidwa kwa mtima, chibayo cha aspiration (kukhudzidwa kwa m'mapapo komwe kumakhala ndi reflux yamadzimadzi kuchokera m'mimba), pulmonary embolism, myoglobinuric aimpso kulephera (impso kulephera ndi kupezeka kwa magazi mumkodzo) , kapena kufalitsa intravascular coagulation. (4)

Chiwopsezo cha kufa chokhudzana ndi matendawa ndi pakati pa 20 ndi 30%.