Neuroleptic malignant syndrome in striatonigral degeneration

A case of probable neuroleptic malignant syndrome (NMS) complicating L-dopa withdrawal in striatonigral degeneration is described. This case suggests that the hyperthermia of NMS is due to peripheral heat production associated with severe muscular rigidity secondary to withdrawal of striatal dopamine drive, rather than being centrally mediated by the hypothalamus, which is not involved in striatonigral degeneration.