Neuroleptic malignant syndrome (NMS) is a severe complication of antipsychotics, especially first-generation antipsychotics such as haloperidol, which was the first to describe this condition, characterized by fever, rigidity, altered state of consciousness, and dysautonomias. . On the other hand, central pontine myelinolysis (now called osmotic demyelination syndrome) results from acute serum sodium disturbances, such as those that occur in hyponatremia repositions, and could be life-threatening as well than the SNM. The association of these two pathologies is unusual and until now their causal relationship is not clearly known, as a result of the few cases reported. Although the mortality of the neuroleptic malignant syndrome is known, the company of central pontine myelinolysis could increase the morbidity and mortality of this entity, which is why it is necessary to recognize it quickly to prevent the appearance of complications, since it does not have specific treatment. We present the case of a young patient who had these two pathologies, and we consider that the cause of central pontine myelinolysis was haloperidol, as well as NMS. Despite this, this drug continues to be very safe in clinical practice since the appearance of these complications is an idiosyncratic reaction to some type of unknown genetic susceptibility.
Malignant neuroleptic syndrome with central pontine myelinolysis