Editing Neuroleptic malignant syndrome (section)

==Diagnosis==
===Differential diagnosis===
Due to the comparative rarity of NMS, it is often overlooked. Immediate treatment for the syndrome should not be delayed as it has a high mortality of between 10-20%.<ref name =Stringer2017>{{cite book | chapter = Antipsychotics or neuroleptics. | veditors = Stringer JL | date = 2017 | title = Basic Concepts in Pharmacology: What You Need to Know for Each Drug Class | edition = 5th | publisher = McGraw Hill | chapter-url = https://accessmedicine.mhmedical.com/content.aspx?bookid=2147&sectionid=161351718 | isbn = 978-1-259-86107-9 }}</ref>  Differentiating NMS from other neurological disorders can be very difficult.

The diagnosis is suggested on patients with a history of drug exposure to the most common inducing agents such as strong antidopaminergic medications.<ref name="Trollor_2009" /><ref>{{cite book | vauthors = Yandle G, deBoisblanc BP | date = 2014 | chapter = Persistent fever | veditors = Hall JB, Schmidt GA, Kress JP | title = Principles of Critical Care | edition = 4th | publisher = McGraw Hill | chapter-url = https://accessmedicine.mhmedical.com/content.aspx?bookid=1340&sectionid=80033832 | isbn = 978-0-07-173881-1 }}</ref> The [[differential diagnosis]] includes [[serotonin syndrome]],<ref>{{cite journal | vauthors = Christensen V, Glenthøj BY | title = [Malignant neuroleptic syndrome or serotonergic syndrome] | journal = Ugeskrift for Laeger | volume = 163 | issue = 3 | pages = 301–302 | date = January 2001 | pmid = 11219110 }}</ref> [[encephalitis]], [[toxic encephalopathy]], [[status epilepticus]], [[heat stroke]], [[catatonia]] and [[malignant hyperthermia]]. Drugs such as [[cocaine]] and [[amphetamine]] may also produce similar symptoms.<ref name=Str2007/><ref>{{cite journal | vauthors = Sachdev PS | title = A rating scale for neuroleptic malignant syndrome | journal = Psychiatry Research | volume = 135 | issue = 3 | pages = 249–256 | date = June 2005 | pmid = 15996751 | doi = 10.1016/j.psychres.2005.05.003 | s2cid = 25728796 | hdl = 1959.4/unsworks_46263 | hdl-access = free }}</ref><ref name="Trollor_2009" /> Features which distinguish NMS from serotonin syndrome include [[bradykinesia]], muscle rigidity, and a high white blood cell count.<ref>{{cite journal | vauthors = Birmes P, Coppin D, Schmitt L, Lauque D | title = Serotonin syndrome: a brief review | journal = CMAJ | volume = 168 | issue = 11 | pages = 1439–1442 | date = May 2003 | pmid = 12771076 | pmc = 155963 | url = http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=12771076 }}</ref>