LAUSR

This case emphasizes on a strong clinical suspicion and early initiation of treatment in patients with slightest suspicion of NMS. Though rigidity and elevated CK levels are a hallmark of NMS, absence of either does not rule out NMS.[5] A probable explanation given by the previous authors, though not very satisfactory, is that in the absence of rigidity, CK levels may remain normal.[4] CK levels are also affected by other parameters like dehydration, physical exhaustion, etc.[4] Atypical NMS and impending NMS may not have all the features qualifying the diagnostic criteria.[3] This should not delay the initiation of treatment. Dantrolene sodium remains the drug of choice. However, it is not freely available in India, and therefore bromcriptine was initiated as per the protocol and the patient made a remarkable recovery.[1]