We reported a 61-year-old male with a thermoregulation disturbance due to striatonigral degeneration (SND). The patient presented with Parkinsonism at the age of 57. T 2-weighted MRI showed hyperintense lesions in the bilateral putamen. He was admitted to our hospital for rehabilitation. Neurological examination demonstrated dysarthria, dysphagia, rigidity, tremor in the right hand, bradykinesia, exaggerated patella tendon reflexes, positive Babinski's sign, and signs of autonomic dysfunction including orthostatic hypotension, urinary retention, and sweating disturbance in the body and extremities. The patient's Barthel index was 5 and he commenced ROM exercise and endurance training in a long-term setting. Tracheotomy was performed because of vocal cord abductor paralysis 3 days after his admission. Tube feeding was initiated since the patient's dysphagia worsened. Thereafter, his high fever persisted for about 3 weeks. Laboratory examinations failed to demonstrate any remarkably abnormal findings, and antibiotics were not effective. There was no sympathetic skin response on the right palm. It was concluded that the patient's hyperthermia was caused by his sweat disturbance. His fever abated when the room temperature was lowered, and the training was started again. When hyperthermia due to autonomic dysfunction is observed in patients with SND, it is necessary to control the room temperature during rehabilitation.

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