Dopamine D1 and D2 receptors were determined in brain tissue taken post mortem from schizophrenic patients previously known to have had tardive dyskinesia and yet who had not received neuroleptic drug treatment for over one year prior to death. In comparison with age-matched control subjects, diminished D2 receptor density was observed in striatal regions, while these receptors appeared to be increased in the pallidum, an area of the brain particularly implicated in the production of dyskinesias. D 1 receptors showed similar tendencies to lower numbers in the striatum in tardive dyskinesia.

Acute disseminated encephalomyelitis (ADEM) is an uncommon acute, rapidly progressive autoimmune demyelinating disease of the central nervous system that is most often due to infection or immunization. Generally, it is monophasic, but there is potential for recurrence and risk for development of multiple sclerosis. Although there has been literature documenting autonomic dysreflexia and hypertensive emergency in 2 pediatric cases of ADEM, to our knowledge there has not been a case detailing paroxysmal sympathetic hyperactivity in an adult patient with ADEM. This case report describes a fulminant case of ADEM and serves to expand the list of diagnoses associated with paroxysmal sympathetic hyperactivity.