Am J Psychiatry 1988; 145:617-620
Copyright © 1988 by American Psychiatric Association
Hypothalamic pathology in the neuroleptic malignant syndrome
E Horn, B Lach, Y Lapierre and P Hrdina
Department of Psychiatry, Royal Ottawa Hospital, Ont., Canada.
The pathogenesis of the neuroleptic malignant syndrome is currently
unclear, and no specific morphological abnormalities in the CNS of victims
of neuroleptic malignant syndrome have been described. The authors report a
case of neuroleptic malignant syndrome with recent foci of necrosis in the
anterior and lateral hypothalamic nuclei. They discuss the role of
tricyclic antidepressants, monoamine oxidase inhibitors, and neuroleptics
in the development of this syndrome. They conclude that although the
pathogenesis of the neuroleptic malignant syndrome is still not clear,
necrosis of the hypothalamic nuclei may be pathognomonic for this syndrome.
