In any patient treated with antidopaminergic agents who presents with mental status changes, muscle rigidity, high fever, and signs of dysautonomia—especially those with complications such as arrhythmia, rhabdomyolysis, hyperkalemia, renal failure, seizures, leukocytosis, and elevated CPK and LDH levels—the possibility of NMS should be strongly considered. The gene discussed is PIK3C2A; the disease is dysautonomia.