Neuroleptic malignant syndrome or parkinsonism hyperpyrexia syndrome

Semin Neurol. 1991 Sep;11(3):228-35. doi: 10.1055/s-2008-1041226.


NMS is a rare and idiosyncratic reaction that occurs with the use of dopamine antagonists or the withdrawal of dopamine agonists from patients with IP. It is a clinical diagnosis based on the presence of parkinsonism and hyperpyrexia in the appropriate pharmacologic setting. If any of these factors is absent, the diagnosis cannot be made. NMS is probably caused by the reduction of dopaminergic activity in the CNS, mainly in the hypothalamus and striatum. Prompt recognition and initiation of supportive and specific therapies optimize survival. Reexposure to neuroleptic drugs, if necessary, is usually possible if done cautiously. Considering that NMS is not solely related to neuroleptics and is less often malignant than not, perhaps the name should be changed to reflect its principal clinical features and underlying pathogenesis. We suggest parkinsonism hyperpyrexia syndrome.

Publication types

  • Review

MeSH terms

  • Dopamine / physiology
  • Fever / chemically induced*
  • Fever / diagnosis
  • Fever / physiopathology
  • Humans
  • Neuroleptic Malignant Syndrome / diagnosis
  • Neuroleptic Malignant Syndrome / physiopathology*
  • Neuroleptic Malignant Syndrome / therapy
  • Parkinson Disease, Secondary / diagnosis
  • Parkinson Disease, Secondary / physiopathology*
  • Syndrome


  • Dopamine