A 35 year old man with a history of schizophrenia is brought to the ER by his friends due to drowsiness. On examination he is generally rigid. A diagnosis of neuroleptic malignant syndrome can be made excepting:

The key is D. Usually occurs after prolonged ttreatment. [Neuroleptic malignant syndrome is a life-

threatening reaction that can occur in response to neuroleptic or antipsychotic medication. Symptoms

include high fever, confusion, rigid muscles, variable blood pressure, sweating, and fast heart rate.

Malignant neuroleptic syndrome usually occurs SOON after start or in increasing dose of antipsychotic

drugs. All others conditions mentioned are seen in this syndrome like renal failure, pyrexia, elevated

creatinine kinase, tachycardia etc].