Neuroleptic malignant syndrome and preexisting brain damage.

A case of neuroleptic malignant syndrome (NMS) is described in a congenitally brain-damaged deaf patient. The literature suggests that NMS in patients with organic brain syndrome is induced by a reduction of marginal stores of dopamine in the hypothalamus and basal ganglia resulting from dopamine-blocking activity of neuroleptics, even at conventionally low doses. Brain-damaged patients should be recognized as being at higher risk of developing NMS.