Neuroleptic malignant syndrome—an unrecognized problem in elderly patients with psychiatric illness?

Until recently, neuroleptic malignant syndrome (NMS) was considered to be most unusual in elderly patients. During a two‐year period, we encountered five patients with the syndrome among some 13000 admissions to our acute geriatric assessment beds. As there have been few other reports of the syndrome in elderly patints, we believe that many cases go unrecognized. All of our patients had existing neurological and/or psychiatric illness which tended to mask the clinical features and in some cases this may have contributed to a delay in making a diagnosis. A delayed diagnosis in NMS can have serious consequences, as early recognition with appropriate intervention offers the best prospect of reducing the high mortality rate.