Neuroleptic Malignant Syndrome on Chronic Trifluoperazine Therapy: A Diagnostic Dilemma

Neuroleptic malignant syndrome (NMS) is a rare, life-threatening reaction to antipsychotic medication. This report describes the case of a 62-year-old male with chronic trifluoperazine use who presented with fever, rigidity, and altered mental status. Although sepsis or meningoencephalitis was initially suspected, an elevated creatine kinase and fulfillment of Levenson's criteria confirmed the diagnosis of NMS. The patient's condition improved following supportive care, administration of bromocriptine, and lorazepam. This case highlights the diagnostic challenges of NMS in patients on a stable antipsychotic regimen and underscores the importance of early recognition, particularly after excluding infectious etiologies.