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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 pregnancy complicated by malignant hyperthermia susceptibility is reported. Serum CPK and electrolyte concentrations were measured during pregnancy and labour. Labour and delivery were managed successfully under epidural analgesia using plain bupivacaine 0.5%.
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PMID:Malignant hyperthermia susceptibility. Management during pregnancy and labour. 42 40

A case of possible malignant hyperthermia in a 6-month-old child is presented. Malignant hyperthermia was manifested in this patient by persistent metabolic acidosis in the intraoperative and postoperative periods, by a rapid rise in temperature with concomitant unresponsiveness in the postoperative period, and by a positive caffeine-halothane stimulation test. The malignant hyperthermia occurring in the postoperative period resolved promptly following administration of dantrolene sodium. An unusual aspect of this case is that both of the child's parents had normal CPK values and negative caffeine-halothane stimulation tests.
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PMID:Management of suspected malignant hyperpyrexia in an infant. 57 Dec 20

A 31-year old male developed malignant hyperthermia (MH) during the initial minutes of Halothane induction. CPK rose to 6120 U/ml and decreased to normal levels as the patient became afebrile over a 10 day period of cooling measures and metabolic management. Muscle weakness, predominantly proximal and depressed deep tendon reflexes were found upon examination during convalescence. Muscle biopsy showed neurogenic changes characterized by fiber type grouping and targetoid fibers. CPK was elevated in one of the patient's children. This case supports the view of underlying hereditary neuromyopathy in MH.
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PMID:Neuromyopathy in malignant hyperthermia. 58 Feb 62

We report a case of malignant hyperthermia in a man of 41 years during his 13th general anaesthesia. All previous anaesthetics were quite normal. Musculoskeletal abnormalities and increased CPK-levels are to be found in some members of the patient's family. The combined use of suxamethonium and halothane might have caused the development of malignant hyperthermia. As a concept of the aetiology of the syndrome the case history indicates that it may be stress-related.
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PMID:[Malignant hyperthermia during the 13th general anaesthesia (author's transl)]. 71 53

Malignant hyperpyrexia is a dangerous complication of general anesthesia occurring in individuals with an underlying disease of muscle. The essential clinical features of the syndrome are a drastic and sustained rise in body temperature, metabolic acidosis, and widespread muscular rigidity. The results of experiments on susceptible pigs and in vitro studies of human muscle have shown that all the clinical features of the syndrome can be explained by a raised level of calcium ions in the myoplasm. This is caused by a massive and sudden release of calcium into the myoplasm from the calcium-storing membranes in the muscle cell when exposed to general anesthetic agents. Two myopathies predisposing to malignant hyperpyrexia have been identified. One is usually subclinical, dominantly inherited, and manifested only by raised serum CPK levels. The other occurs in young boys with a number of physical abnormalities, whose relatives are unaffected. The serum CPK is a useful screening test in families in which malignant hyperpyrexia has occurred. Unfortunately, though, the serum CPK is not a specific test, and in doubtful cases the only unequivocal method of establishing susceptibility to malignant hyperpyrexia is to carry out an in vitro muscle test in which the muscle is exposed to caffeine, halothane, succinylcholine, and potassium chloride. Susceptible individuals should be given local, regional, or spinal anesthesia if an operation is needed. If this form of anesthesia is unsuitable, barbiturates such as thiopentone, tranquilizers such as diazepam, narcotics such as Pantopon, and neuroanaleptics such as fentanyl, nitrous oxide, d-tubocurarine, and althesin appear to be safe. By far the most important aspect of treatment is prophylaxis. Early diagnosis and immediate cessation of the offending anesthetic agents are the most important factors in trying to reduce the very high mortality of the syndrome.
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PMID:Malignant hyperpyrexia. 77 64

Malignant hyperthermia is a rare but severe complication of modern anesthesia, induced by halothane and succinylcholine. The syndrome is characterized by a rapid sustained and extreme rise in body temperature associated with muscular rigidity, tachycardia, tachypnoea and cyanosis. The lethality is about 60%. The present paper describes the histological, histochemical and electron microscopical findings performed on muscle biopsies of 3 patients with malignant hyperthermia (1 patient died) and a so called risk patient. In all patients morphological findings consistent with a pre-existent myopathy were found. Histologically there were acute necrotic muscular fibers as well as in types I and II, variations in the fiber diameter and centralization of the nuclei. In two cases even fibers that had a normal aspect in HE slides, showed a pathologic pattern after phosphorylase reaction. In addition to acute rhabdomyolysis, electron-microscopic investigations revealed cystic expansion of the cisterns of the sarcoplasmic reticulum with a peculiar proliferation of the sarcolemma. In a degenerating mitochondrium, a crystalline inclusion was identified. These findings support the pathogenetic concept of Britt and coworkers of a functional defect in the calcium release or binding mechanism of sarcoplasmic reticulum. Since it is known that malignant hyperthermia has a familial predilection, it seems very important that clinical, biochemical, and morphological investigations be performed such as CPK estimations and muscular biopsies not only of the patients but also of the relatives in order to rule out this type of latent myopathy.
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PMID:[Histological, histochemical, and ultrastructural findings in malignant hyperthermia (author's transl)]. 80 99

General anaesthesia with Althesin was administered on two occasions to a patient who was identified as susceptible to malignant hyperthermia, in whom there was identified familial subclinical myopathy and once in another patient suffering from arthrogryposis multiplex congenita with a history of fever associated with two previous anaesthetics. In the first patient halothane was administered by accident in association with the Althesin, but no hyperpyrexia occurred. In the second instance nitrous oxide-oxygen and halothane were associated purposely with Althesin. In none of these cases was there any rise in temperature, muscle rigor or elevation of the serum CPK level. This experience corroborates the experimental evidence of Hall, et al.10 and Harrison, who reported that Althesin prevented the onset of hyperthermia, and the clinical reports of Page and Judelman. Althesin can be assumed to be an effective anaesthetic for malignant hyperthermia susceptible patients.
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PMID:Malignant hyperthermia and althesin. 89 May 63

In addition to two published cases of malignant hyperthermia (M.H.) 13 more cases have been observed in this institution since 1971, which are probably early reactions of the M.H. type. All 13 patients were children, 3-12 years of age, who developed a rigor of the jaw muscles after succinyldicholine and/or halothane within minutes after the induction of anesthesia. Further symptoms that could be observed regularly were a tachycardia of several hours duration and a marked elevation of the serum CPK-activity with a peak after 24 hours. Since the anesthesia was terminted immediately and the operations postponed as soon as a M.H. reaction was suspected, the rise in body temperature was minimal or absent and exceeded in no case 39 degrees C. Several children were operated upon later in neuroleptanalgesia (NLA) supplemented by nitrous oxide without any muscle relaxants. None of these children developed the aforementioned symptoms rigor, techycardia and CPK-elevation. One child had Alloferin in addition to NLA-nitrous oxide-anesthesia. This child had postoperatively a tachycardia lasting several hours and 24 hours later a serum CPK activity of 1500 U/1. Since this CPK activity is higher than in comparable cases (see fig. 1) it is concluded, that the nitrous oxide-NLA sequence appears to be safe for patients susceptible to M.H. Alloferin however must probably be regarded as a trigger agent for M.H.
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PMID:[Mild form of malignant hyperthermia? OR, ABNORMAL REACTION To succinyldicholine?]. 96 89

Our purpose was to determine whether an apparently healthy patient who died under general anaesthesia had malignant hyperpyrexia by examining her relatives and to suggest protective measures for the relatives of the deceased patient against this complication during future general anaesthetics. The family members of the deceased patient were examined systematically to determine whether or not they were prone to develop malignant hyperpyrexia. Raised serum CPK and aldolase levels, EMG changes, histopathological examination of the striated muscle, diminished muscle power during an ergometric test, and subjective symptoms revealed that other members of her family had muscular dystrophy. Our results support the theory that during general anaesthesia patients with muscular dystrophy are prone to develop malignant hyperpyrexia. Although muscular dystrophy is uncommon in Finland, affected persons should be catalogued, and preventive measures against malignant hyperpyrexia taken if they ever have to have a general anaesthetic.
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PMID:Malignant hyperpyrexia. A study of an affected family. 113 33

Malignant hyperthermia is a pathophysiologic process, the occurrence of which is nearly impossible to predict, the diagnosis difficult to discover rapidly, and the treatment unsuccessful in the majority of cases as is borne by the high mortality rate. It is in almost all instances, a fortuitous event, and liability will most probably not be imposed unless the plaintiff can establish by way of expert testimony that defendant-anesthesiologist departed from acceptable methods of care. Definite departures from the present standard of care could be: (1) administering a potent general anesthetic utilizing halogenated inhalation agents and depolarizing muscle relaxants to an individual who has undergone a previous malignant hyperthermia episode, and possibly to a member of his immediate family; (2) failing to have available appropriate resuscitative equipment; and of course, (3) lack of diligence and due care in attempting to treat a case of malignant hyperthermia. It seems, at this point, that serum CPK levels and constant temperature monitoring are additional safeguards, but are not part of the standard of care imposed upon the anesthesiologist.
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PMID:Malignant hyperthermia during general anesthesia: medicolegal considerations. 122 Dec 38


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