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William T. Talman, MD; Gery Florek, MD; Dennis E. Bullard, MD

Arch Neurol. 1988;45(9):1037-1040.

Abstract
• Although intracranial hypertension may cause autonomic disturbances, as well as alterations in the regulation of body temperature, an acute hyperthermic syndrome with autonomic disturbance as a consequence of hydrocephalus has not been described previously. Two subjects presented with such a syndrome, with each of several episodes of acute shunt failure and hydrocephalus. With correction of the hydrocephalus, the autonomic disturbances and fever immediately cleared. Observations from human and experimental studies suggest some potential mechanisms for the development of the syndrome. One of the subjects of this report was being treated with neuroleptics at the time of hospitalization; in him, and potentially in other similar patients, the syndrome could easily be confused with the neuroleptic malignant syndrome. The need for prompt appreciation of the correct diagnosis was emphasized by the rapid clearing of all neurological signs after correction of the shunt malfunction in both of these patients.

Author Affiliations
From the Department of Neurology, University of Iowa College of Medicine and the Veterans Administration Medical Center, Iowa City (Drs Talman and Florek); the Department of Neurological Surgery, Duke University Health Care Center (Dr Bullard), and the Veterans Administration Hospital (Dr Bullard), Durham, NC.

Footnotes
Accepted for publication March 25, 1988.

Reprint requests to Department of Neurology, The University of Iowa, Iowa City, IA 52242 (Dr Talman).

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