Case study: neuroleptic malignant syndrome without pyrexia.

Fever is generally considered to be an essential feature of neuroleptic malignant syndrome (NMS). The authors present the case of a 12-year-old boy who had many features of NMS but did not have fever. This case emphasizes the importance of assessing the total clinical situation. It also supports the concept of neuroleptic-induced catatonia (NIC) and NMS as disorders on the same spectrum. A scoring system is offered as a guide to severity of NIC-NMS.