Malignant syndrome of two Parkinson patients due to withdrawal of drugs.

Dear Editor, Neuroleptic malignant syndrome (NMS) is characterised by the impairment of consciousness, high fever, rigidity and autonomic instability. Although originally described in patients taking neuroleptic drugs, this syndrome may also occur in patients with Parkinson’s disease (PD) during withdrawal or reduction of levodopa therapy or other dopaminergic drug therapy and is called malignant syndrome (MS) or neuroleptic-like syndrome.1,2 Dehydration, antiparkinsonian drug withdrawal, infections and hot weather are considered to trigger this syndrome. Diagnostic criteria were originally proposed by Levenson.3 Two patients with PD who developed MS, one of whom suffered from severe cerebral degeneration, are presented.