Hypothalamic pathology in the neuroleptic malignant syndrome

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.