Which of the following statements regarding the clinical characteristics of NMS is correct?

A. Hyperthermia associated with “classic” or “full blown” NMS is usually mild.
B. Altered thermoregulation is the sole explanation for elevated body temperature.
C. Dehydration seldom occurs in patients experiencing NMS.
D. Muscular hypertonicity associated with NMS is described as generalized lead-pipe muscle rigidity.
E. Alterations in consciousness are not routinely seen with NMS.
 

• Answer D is correct.

• Lead-pipe rigidity develops shortly before or concomitantly with onset of fever and is usually accompanied by tremors.

• Hyperthermia in “classic” or “full blown” NMS is generally severe and can range from 38.5 to 42 C (101.3 to 107.6 F); however, there may be many less obvious cases with mild temperature elevations.

• Altered thermoregulation due to dopamine blockade in the hypothalamus is only partially responsible for the elevated core body temperature.  Increased heat production from muscle contractions and reduced heat transfer due to vasoconstriction also contribute to the elevated core body temperature.

• Profuse diaphoresis in response to increased body temperature, tachypnea, and poor oral intake can result in severe dehydration. Some persons will go on to develop acute renal failure.

• Alterations in consciousness, which fluctuates from alert but dazed to stupor and coma, are common in persons with NMS.

 

References:  3, 4, and 5

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