[A case of mitochondrial encephalomyopathy with schizophrenic psychosis, dementia and neuroleptic malignant syndrome].

A 37-year-old male with an 8-year-history of schizophrenic psychosis and dementia developed hyperpyrexia and cataleptic rigidity during haloperidol administration. He was transferred to our hospital where he was noticed to have generalized muscle weakness and atrophy. In his muscle biopsy, there were numerous ragged-red fibers and focal cytochrome c oxidase deficiency. In addition, the presence of strongly SDH-reactive blood vessels (SSV) in his muscle biopsy suggests that the similar systemic vascular abnormality as seen in MELAS plays a certain role for inducing the central nervous system symptoms. He discontinued haloperidol, and was placed on coenzyme Q and idebenone which were effective for his psychic problems. Several months later, his schizophrenic symptom disappeared and mental status improved from IQ of 60 to 68. We would emphasize that mitochondrial encephalomyopathies must be taken into account for differential diagnosis for psychiatric patients with mental deterioration.