Complications

Complication
Timeframe
Likelihood
short term
medium

May occur due to deterioration. Should be managed promptly in line with local protocols.[53]

Sepsis

short term
medium

May occur from dehydration or rhabdomyolysis.

Creatine kinase levels and hydration status should be carefully monitored.

Acute kidney injury

short term
low

Non-convulsive status epilepticus can have similar clinical features to NMS.

Status epilepticus

short term
low

Progressively high creatine kinase levels and myoglobinuria. Can be fatal.

Patients may need dialysis if rhabdomyolysis occurs.[69]

Rhabdomyolysis

short term
low

Secondary to immobility associated with catatonia or rigidity.

Pulmonary embolism

short term
low

Secondary to obtundation or dysphagia.

Aspiration pneumonia

long term
low

Cognitive impairments have been reported. It is often difficult to distinguish from pre-existing cognitive impairment (e.g., dementia, psychosis).[30]

long term
low

The nervous system is very vulnerable to injury by hyperthermia, and in cases where body temperature has been extremely high or hyperthermia has persisted for a long time, patients have suffered permanent injury to the central nervous system or peripheral nerves.

variable
high

Subsequent medication choices may be limited.

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