• Neuroleptic Malignant Syndrome (NMS) is a rare, but true neurological emergency which is today associated with much lower mortality given heightened awareness about the condition.

• It typically initially begins with muscle rigidity resulting in rhabdomyolysis, followed by high fever, and delirium.

• Always check creatinine phosphokinase (CPK) and white blood cell levels when concerned about NMS, as these typically elevate in response to muscle breakdown.

• The following mnemonic (FEVER) serves as a reminder of the signs and symptoms associated with NMS:

           F - Fever (anything over 100.4 F counts)

            E - Encephalopathy

           V - Vital signs instability

           E - Enzymes elevation (i.e. CPK)

            R - Rigidity of muscles