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The paper deals with recent aspects of diagnosis and treatment of neuroleptic malignant syndrome (NMS). NMS is an antipsychotic-induced, life-threatening condition, characterized by hyperpyrexia, muscle rigidity, qualitative alteration of consciousness and autonomic nervous system dysregulation. NMS prevalence and mortality rates have declined over the past 30 years, most likely due to early recognition of the syndrome and appropriate intervention. Recent reports suggest a prevalence of 0.02-0.03%, and 5.6% mortality. Treatment includes withdrawal of the offending dopamine antagonist, supportive care and may include the use of specific pharmacotherapies (benzodiazepines, bromocriptine, amentadine, dantrolene) and electroconvulsive therapy. Nonetheless, clinicians, especially primary care clinicians who are using antipsychotics more often for adjunctive treatments, must be cognizant of this syndrome. [ABSTRACT FROM AUTHOR]

Franková V, Horská I, Kastner J. Intracranial tumors in geriatric psychiatry Objective: Psychiatric symptoms may be the first and dominating clinical manifestation of intracranial tumors in older age. The aim of our study was to investigate the typical psychiatric symptoms of intracranial tumors in psychogeriatric patients which should definitely indicate neuroimaging. Material and method: We performed retrospective analysis of medical records of patients admitted to the psychogeriatric department of Psychiatric hospital in Dobrany due to symptoms of intracranial tumors in 2012-2014. Case reports are presented. Results: In a three-years period 1520 patients were admitted, 6 of them (0,4 %) (4 women, 2 men) due to symptoms of intracranial tumors. There were: psychiatric and behavioral disturbances and delirium after neurosurgery, in inoperable tumors and in newly diagnosed tumors. These common symptoms are found as first manifestation of intracranial tumors in our patients: fluctuation of symptoms, rapidly progressive cognitive decline, delirium, depression, anxiety, atypical psychotic symptoms, weight changes, sleep disturbances, vertigo and gate disturbances. Conclusion: Neuroimaging (CT and/or MRI scan) is an important part of differential diagnosis of dementia, especially atypical type with rapid progression. Neuroimaging should be also considered in psychogeriatric patients with new-onset or atypical psychosis and affective disorders, personality and behavior changes and anorexia. [ABSTRACT FROM AUTHOR]