The authors examined the autopsied brains from three patients who had a
fatal hyperthermia syndrome. There was marked hypothalamic noradrenaline
depletion in all three patients, severe brain choline acetyltransferase
deficiency with nucleus basalis cell loss in two patients, and mild to
moderate brain choline acetyltransferase loss in one patient. Striatal
dopamine metabolite/dopamine ratio was below normal in two patients and not
elevated, as would be expected after short-term neuroleptic administration,
in the third. This suggests that reduced capability (aggravated by the
cholinergic deficit) of the nigrostriatal dopamine system to respond
adequately to stress and/or neuroleptic-induced receptor blockade may be
important in the development and course of fatal hyperthermia syndrome.Abstract Teaser