[A ten-year-old autistic girl with neuroleptic malignant syndrome caused by neuroleptic agents].

We reported a ten-year-old autistic girl who had developed neuroleptic malignant syndrome (NMS) caused by administration of neuroleptic agents, haloperidol and chlorpromazine, because of her behavioral disorders. She had fever (38.4 degrees C) and elevated CK (796 IU). Her extrapyramidal symptoms and autonomic disturbance improved gradually after discontinuation of these drugs. However, altered consciousness did not change for three months despite treatment with L-DOPA, bromocriptine, dantrolene Na, biperiden, diltiazeM HCL and diazepam. Administration of amantadine HCL dramatically cleared not only the persistent symptom but also extrapyramidal symptoms and autonomic disturbance. She recovered from NMS one month later. The study of this case indicated that these neuroleptic drugs could cause NMS also in children. Therefore, the use of them in children with behavioral problems should be carefully evaluated clinically. It was concluded that NMS in this case occurred due to a defective dopamine release from presynaptic vesicles because L-DOPA was not effective and amantadine HCL was effective against these symptoms.