Rhythmic Delta Activity beyond Neuroleptic Malignant Syndrome

A male patient in his 70s with schizophrenia presented with worsening hallucinations.Switching from olanzapine to asenapine and brexpiprazole stabilized his psychogenic condition and allowed him to communicate well.However, the patient developed a fever of 39C and experienced further impairment of consciousness.Muscle stiffness was evident throughout his body, and laboratory tests revealed a markedly elevated serum creatine kinase (CK) level of >15,000 IU/L.Intravenous dantrolene under mechanical ventilator support dramatically improved his muscle stiffness and CK levels; however, his consciousness remained impaired.Electroencephalography (EEG) revealed lateralized rhythmic