Rapid, increasing signs of extrapyramidal symptoms (EPS) is an important key feature of NMS. EPS, associated with conventional antipsychotics, occurs in about 95% of NMS cases. The potential for atypicals to produce EPS symptoms in NMS is comparable to that of conventional antipsychotics.


NMS generally presents within 1–3 days of exposure to a dopamine antagonist or withdrawal of a dopamine agonist. A laboratory profile of a patient with NMS should exhibit low serum iron levels, and considerably elevated creatine kinase (CK) and white blood cells.  Laboratory findings may be useful in differentiating the two syndromes.


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