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Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of malignant hyperthermia (MH) in a three-year eight-month-old girl is presented. Definite symptoms of MH developed in the awake patient 30 min after termination of anaesthesia which had lasted five hours. This postoperative MH-episode resolved promptly following intravenous administration of dantrolene (2.5 mg X kg-1 initially, followed by 5 mg X kg-1 over 12 hours). Results of serial serum samples revealed a steady increase in creatine kinase (CK) concentration with the highest value being observed at the second day, despite dantrolene therapy. The unusual occurrence of MH in the postoperative period, when the major effects of anaesthesia were no longer an important consideration, is discussed with regard to the "human stress syndrome." The necessity to give this information to people usually not familiar in diagnosing MH (e.g., medical personnel in surgical wards) is stressed.
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PMID:Postoperative malignant hyperthermia and dantrolene therapy. 664 Apr

Two schizophrenic patients developed muscular rigidity, stupor, and hyperpyrexia consistent with neuroleptic malignant syndrome, 8 to 10 days after starting haloperidol therapy. Muscle rigidity was not affected by etybenzatropine or diazepam, but dantrolene, a direct-acting skeletal muscle relaxant, provided muscle relaxation with a concomitant decrease of fever and serum creatine kinase. Neuroleptic malignant syndrome and malignant hyperthermia are clinically similar, and dantrolene is effective in both; suggesting a muscular origin of fever in these two diseases.
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PMID:Beneficial effects of dantrolene in the treatment of neuroleptic malignant syndrome: a report of two cases. 668 1

Administration of succinylcholine to normal individuals results in alterations in muscle membrane integrity expressed as a slight increase in the concentrations of creatine phosphokinase (CK) in serum and appearance of small amounts of myoglobin in the urine, but without clinical symptoms. Subjects with strabismus due to congenital muscular dystrophy may develop more significant rhabdomyolysis expressed as muscle stiffness and weakness, massive myoglobinuria, marked elevation of serum CK and other enzymes, metabolic acidosis, tachycardia and moderate elevation of body temperature. In some cases grave malignant hyperthermia with significant hypoxia, metabolic acidosis, tachycardia and marked abnormalities in serum electrolyte concentrations may cause irreversible damage to the central nervous system and other vital organs and death. A case of difficult anaesthesia for a six year old boy belonging to family affected with muscular dystrophy is presented. More attention must be given to preoperative examination (anamnesis, serum enzymes) or ophthalmological patients and more careful monitoring during anaesthesia and in the early postoperative period must be instituted to prevent and treat complications induced by succinylcholine and volatile anaesthetic agents.
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PMID:Strabismus as a possible sign of subclinical muscular dystrophy predisposing to rhabdomyolysis and myoglobinuria: a study of an affected family. 710 7

Resting metabolic rate and the energy cost of performing a specific (light work load on a bicycle ergometer were measured in nine subjects susceptible to malignant hyperpyrexia (MHS) and nine control subjects, both fasting and following a 600-kcal meal. Blood glucose, lactate, pyruvate and serum triglycerides, thyroxine, cortisol, creatine kinase, growth hormone, and calcium and potassium levels at rest and immediately following exercise, after fasting and eating, were measured. There was no evidence of increased heat production in the MHS subjects compared with controls. The MHS subjects, however, showed a complete absence of dietary-induced thermogenesis with exercise. Compared with the controls, MHS subjects had higher insulin levels for essentially the same blood glucose values. Triglycerides in the MHS group rose steadily over the course of the experiment, whereas in the controls they did not vary from the initial value. Lactate did not rise as much with exercise in the MHS group but did nor fall with rest, and pyruvate did not change from resting fasting values, whereas in the controls it rose steadily. Differences were also found in thyroxine and cortisol levels between the MHS and control groups. The shunting of blood away from thermogenic tissue is suggested as a mechanism for the absence of diet-induced thermogenesis with exercise in the MHS group and the possibility of an underlying abnormality of cardiovascular (sympathetic) control mechanisms in these subjects is discussed. The biochemical abnormalities are discussed in relation to previous biochemical data from MHS humans and pigs and in relation to the abolition of dietary-induced thermogenesis.
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PMID:Metabolic rate and blood hormone and metabolite levels of individuals susceptible to malignant hyperpyrexia at rest and in response to food and mild exercise. 724 57

Malignant hyperthermia is an autosomal dominant disorder with variable expressivity that is caused by a membrane defect in the sarcolemma of myofibrils. A patient with strabismus (esotropia) had tachycardia and masseter muscle rigidity on exposure to succinylcholine chloride and halothane, but because of rapid recognition of the condition and discontinuation of the procedure, the potentially lethal complications of malignant hyperthermia did not develop. A serum creatine phosphokinase level showed a substantial increase above normal. Two weeks later, the patient underwent successful correction of the strabismus under general anesthesia, using morphine sulfate and thiopental sodium without complication. This condition is of interest to ophthalmologists because it occurs with increasing frequency in patients with strabismus and ptosis, and it may be triggered by certain local anesthetic agents often used by ophthalmologists.
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PMID:Suspected malignant hyperthermia in a strabismus patient. A case report. 725 98

Malignant hyperthermia developed in a 4-year-old Thoroughbred horse following 3 hours and 15 minutes of halothane anesthesia, with supplementary succinylcholine. Clinical signs included fever, sweating, hyperventilation, tachycardia, and decreased blood pressure followed by a rapid increase in blood pressure. Biochemical aberrations included hypocalcemia, hyperkalemia, hyperphosphatemia, myoglobinuria, and high creatine phosphokinase and ornithine carbamyl transferase activities. Treatment consisted initially of surface cooling with cold water, alcohol and ice, IV administration of cooled balanced electrolyte solutions and sodium bicarbonate, and removal from the anesthetic and rebreathing circuit. Oxygen was given by endotracheal insufflation. The rectum was then packed with ice, the horse was moved to a recovery raft and pool, and his body was packed in ice. Xylazine and dantrolene were given during recovery from anesthesia. Following recovery, treatment consisted of administration of balanced electrolyte solutions, calcium borogluconate, potassium penicillin, meperidine, and additional dantrolene. Muscle biopsy demonstrated exaggerated contracture responses to halothane and caffeine, confirming a diagnosis of malignant hyperthermia. The horse was returned to training following a routine postsurgical convalescent period.
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PMID:Malignant hyperthermia in a halothane-anesthetized horse. 734 3

Malignant hyperthermia developed in the 94th minute of anesthesia undergone by a nearly 5-year-old girl. Two minutes after re-filling the halothane vaporizer, muscle rigor and tachyarrhythmia occurred. Massive myoglobinuria setting in on the day of operation reached its peak on the 1st postoperative day. Only following this were the highest CK activities to be recorded. CK-BB could not be detected at any time.
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PMID:[Malignant hyperthermia. I. Observations in connection with its pathogenesis and course (author's transl)]. 737 28

Skeletal muscle may release creatine kinase (CK) during a malignant hyperthermia (MH) episode; however, muscle damaged during surgery may also release CK. This study examined the overlap between peak plasma CK levels in patients suspected of having had a MH episode (data obtained from North American MH Registry) and previously published CK changes occurring after common surgeries. For patients who were subsequently proven to be MH positive by muscle biopsy, there was considerable overlap. This was most significant with surgeries having substantial tissue damage, such as major vascular surgery and abdominal surgery. Overlap was much less with minimally invasive surgery, such as cystoscopy. Approximately 30% of MH positive patients treated with dantrolene had peak CK in the range of most surgical procedures, and approximately 50% of MH positive patients not given succinylcholine had peak CK similar to those of most surgical procedures. Dantrolene did not significantly alter peak CK in MH positive patients; however, succinylcholine was associated with significantly higher peak CK. These data suggest that patients who have had an acute MH episode during a surgical procedure may have peak CK values within the range of CK values expected from the procedure itself.
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PMID:Creatine kinase alterations after acute malignant hyperthermia episodes and common surgical procedures. 748 44

Neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) may have a common pathogenic mechanism; therefore, it has been suggested that known triggering agents for MH (such as succinylcholine) should be avoided in patients with NMS. Electroconvulsive therapy (ECT) continues to play a major therapeutic role in contemporary psychiatry, and succinylcholine has been the muscle relaxant of choice in attenuating violent muscle contractions induced by ECT. Mivacurium is a non-depolarizing muscle relaxant with a relatively rapid onset and a short duration of action, and to date it has been proved safe in MH-susceptible patients. In this case report, following succinylcholine use during ECT, a patient with NMS developed an increase in temperature and serum creatine kinase (CK) level, possibly due to an MH reaction. Since the patient's mental status necessitated further ECT, mivacurium was administered during subsequent treatment and resulted in effective attenuation of muscle contractions without elevation of patient temperature or CK levels. In addition, there was no marked prolongation of the anaesthetic. Mivacurium is a suitable agent for patients with NMS undergoing ECT, as it has not been associated with precipitation of an MH response.
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PMID:Neuroleptic malignant syndrome and mivacurium: a safe alternative to succinylcholine? 795 1

Multicore myopathy is a rare congenital myopathy. The multicores consist of numerous small areas of decreased oxidative enzyme activity. The long axis of the lesion is perpendicular or parallel to the long axis of the muscle fiber. These cores are usually smaller than central cores. For this reason they are also called minicores. Although the multicores represent a nonspecific change in that they can be observed in malignant hyperthermia, muscular dystrophy, inflammatory myopathy, etc. Muscular weakness dating from early infancy is combined large proportion of the muscle fibers. In about half of the reported cases the muscular weakness has not been progressive, while in the others a slow progression has occurred. This 9-year-old boy presented with congenital nonprogressive myopathy associated with thoracic scoliosis and bilateral equinovarus deformity. The serum creatine phosphokinase and lactic dehydrogenase levels were normal. Electromyography showed "myopathic" features. The biopsy revealed a marked size variation in myofibers, ranging from 10 microns to 100 microns. A few small angular fibers and slight endomyseal fibrosis were also noted. There was type I fiber predominance. NADH-TR reaction disclosed more well-defined cores with loss of intermyofibrillary mitochondrial activity. These cores were usually located with loss of intermyofibrillary mitochondrial activity. These cores were usually located in the peripheral portions of the myofibers and the core size measured 10-30 microns in diameter. Electron microscopic examination revealed circumscribed areas of disintegrated Z band material and disorganized sarcomeric units near the sarcolemma. A decrease in the number of mitochondria and glycogen particles was noted.
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PMID:Multicore myopathy--a case report. 819 69


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