Neuroleptic malignant syndrome is characterized by which of the following?

• A. Rash and itching
• B. Bradykinesia and hypotension
• C. Craving and euphoria
• D. Fever, muscle rigidity, and altered mental status

Answer: (D)

Neuroleptic malignant syndrome is a life‑threatening reaction to antipsychotic medications that blocks dopamine pathways, leading to a distinctive cluster of symptoms. The best answer describes the classic triad: very high fever, severe muscle rigidity, and changes in mental status. This combination captures the core presentation of NMS and is what clinicians look for when diagnosing it. Rash and itching would suggest an allergic reaction rather than NMS. Bradykinesia and hypotension do not define the syndrome—the rigid, hyperthermic, mentally altered state is the hallmark. Craving and euphoria point to substance effects, not NMS. In practice, recognizing this triad prompts immediate discontinuation of the offending drug and aggressive supportive care, with treatments like dantrolene or bromocriptine used in severe cases.