The range of conditions with which NMS has to be differentiated is quite wide. In particular, the differential diagnosis includes uncomplicated, benign neuroleptic extrapyramidal syndrome. But there are no disturbances of modafinil, hyperthermia, laboratory signs of rhabdomyolysis, and there is no such pronounced muscle hypertonicity that causes rhabdomyolysis. Catatonia, especially its febrile forms (here differential diagnosis is especially difficult, but anamnesis helps, connection with taking antipsychotics or other dopamine antagonists, increasing their dose, canceling or reducing correctors), meningitis, encephalitis, subarachnoid hemorrhage (here differential diagnosis is helped by the study of cerebrospinal fluid).
Malignant hyperthermia (the condition is VERY similar, the differential diagnosis is helped by anamnesis - recent anesthesia with a halogenated gaseous anesthetic, recent administration of succinylcholine). Infectious fever and other conditions occurring with hyperthermia (thyrotoxic crisis, etc.), toxic encephalopathy, serotonin syndrome. But with it, diarrhea is more typical, muscle hypertonicity is not so pronounced, there is no hyperkinesis, rhabdomyolysis, often nausea, vomiting, the connection with the use of antidepressants, and not NL, is important.
Heat stroke (but it is more characterized by dry skin rather than profuse sweating, muscle hypotonia rather than hypertonicity, hypotension rather than hypertension, etc.). Non-convulsive status epilepticus, poisoning with amphetamines, cocaine, alcohol and barbiturate withdrawal syndromes:
- The pathogenesis of NMS is associated with a sharp weakening of dopaminergic neurotransmission in the region of the basal ganglia. What causes extrapyramidal disorders and hypertensionmuscle tone, leading to buy modafinil online calcium release and rhabdomyolysis.
- Increased muscle activity, along with dopaminergic blockade of the autonomic centers of the hypothalamus, causes increased heat production and hyperthermia.
- Dopamine blockade of the autonomic nuclei of the hypothalamus is also responsible for other observed autonomic disorders. Hypercatecholaminemia, hypersympathicotonia, and hypercortisolemia develop.
- Young people under 40 years of age are most predisposed to developing NMS. Moreover, the younger you are, the higher the risk. This may be due to more frequent prescription and, on average, higher doses of NL in young people.
Men are more susceptible than women. Thus, young men are particularly susceptible. There is a role of genetic factors - those patients whose close relatives had NMS during treatment are more predisposed. There is a cross-reaction with malignant hyperthermia—patients who have had episodes of MH to succinylcholine or inhalational anesthetics are more predisposed to MH. Conversely, patients with NMS are more likely to give out MH. More predisposed are those patients to whom antipsychotics were prescribed not for antipsychotic purposes (not to order provigil pills delusions and hallucinations), but for the purpose of relieving agitation and aggressiveness, controlling behavior (i.e., in particular, patients with autism, dementia, mental retardation, etc.) .d.).