Diagnosing subtypes of neuroleptic malignant syndrome: an introduction to the Lee-Carroll Scale

Ann Clin Psychiatry. 2008 Jan-Mar;20(1):47-8. doi: 10.1080/10401230701844893.

Abstract

Background: Neuroleptic malignant syndrome (NMS) shares common features with catatonia and serotonin syndrome (SS). For instance, catatonia is a risk factor for the development of NMS.

Methods: We performed a pilot study to examine if the Lee-Carroll Scale is able to differentiate the proposed NMS subtypes and explore possible relationship between NMS and SS. A consecutive series of cases reported to the Neuroleptic Malignant Syndrome Information Service (NMSIS) were reviewed with 29 cases of "definite NMS." The Hynes-Vickar Scale (an NMS scale), Hegerl Scale (a SS scale), and Lee-Carroll Scale (an NMS subtype scale) were applied to these case report forms.

Conclusions: Although the groups were too small for statistical analysis, the 2 catatonic NMS subtypes appear to have higher NMS scores on the Hynes-Vickar Scale, and lower SS scores on the Hegerl Scale than the non-catatonic NMS subtype. The scores on the Lee-Carroll Scale were highest for non-catatonic NMS subtype. This pilot study suggests that the Lee-Carroll scale may help differentiate the subtypes of NMS, and provides some support that non-catatonic NMS may be a form of SS. NMS subtypes may be important in the early detection and treatment of NMS.

Publication types

  • Letter

MeSH terms

  • Catatonia / chemically induced
  • Catatonia / diagnosis
  • Diagnosis, Differential
  • Humans
  • Neuroleptic Malignant Syndrome / classification
  • Neuroleptic Malignant Syndrome / diagnosis*
  • Neurologic Examination*
  • Pilot Projects
  • Serotonin Syndrome / diagnosis