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Neuroleptic Malignant syndrome caused by dopamine-depleting drugs in a patient with Huntington disease

Neurological Institute, Columbia-Presbyterian Medical Center, New York, NY.

Address correspondence and reprint requests to Dr. Burke, Neurological Institute, Dept of Neurology, 710 W. 168 Street, New York, NY 10032.

Prior reports of neuroleptic malignant syndrome (NMS) concerned patients with psychiatric disorders, usually schizophrenia, who were taking dopamine receptor blocking agents. We report the syndrome in a patient with Huntington disease who was treated with dopamine-depleting agents. He had a negative evaluation for malignant hyperthermia (MH), and we suggest that NMS differs from MH. The occurrence of NMS caused by dopamine-depleting agents suggests that anticholinergic properties of phenotiazines are not the only cause. Central dopaminergic systems probably participate in thermo-regulation, and dopamine depletion probably plays a pathogenetic role in this syndrome.

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