Neuroleptic malignant syndrome – severe atypical case with electroconvulsive therapy

Neuroleptic malignant syndrome (NMS) is an idiosyncratic life-threatening condition requiring prompt recognition and management. This case illustrates severe, atypical NMS with rhabdomyolysis and a creatinine-phosphokinase of 113,300 IU/L. Due to the diagnostic challenge of NMS, electro-convulsive therapy (ECT) has shown benefits in managing severe, atypical, refractory, unresponsive and undifferentiated NMS cases. Further research is needed to confirm ECT’s efficacy through randomised control trials and establish specific inclusion and exclusion criteria for ECT treatment in NMS.