Objective: In this case report we present two cases of NMS associated with sudden drain of DBS batteries (37 years old Caucasian woman and 42 years old Caucasian man) a few years after DBS battery placements.

Background: The neuroleptic malignant syndrome (NMS) is a severe, general, sometimes fatal, physical reaction, induced by sudden and strong blockade of dopamine receptors characterized by hyperthermia, autonomic dysfunction, altered mental state, hemodynamic dysregulation, elevated serum creatine kinase, and rigor. It is most often caused by an adverse reaction to anti-psychotic drugs or abrupt discontinuation of neuroleptic or anti-parkinsonian agents. There are reports in the literature following the discontinuation of anti-parkinsonian drugs during the pre-operative preparation for deep brain stimulation surgery for Parkinson’s disease.

Methods: They were successfully treated with the continuous apomorphine infusion therapy, fluid replacement, and activation of DBS. If PD patients with DBS develop severe rigidity, stupor, and hyperthermia after a few years of battery placement, battery drain should be suspected.

Results: The dopaminergic drug should be restarted and the DBS system should be activated as soon as possible to prevent rhabdomyolysis and renal failure.

Conclusions: The dopaminergic drug should be restarted and the DBS system should be activated as soon as possible to prevent rhabdomyolysis and renal failure.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/malignant-neuroleptic-syndrome-following-a-sudden-deep-brain-stimulation-battery-drain-report-of-two-cases/