Malignant hyperthermia (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Overview[edit | edit source]

Malignant hyperthermia is disease passed down through families that causes a fast rise in body temperature (fever) and severe muscle contractions when the affected person gets general anesthesia.

This condition is not the same as hyperthermia that is due to medical emergencies such as heat stroke or infection.

What are the symptoms of Malignant hyperthermia?[edit | edit source]

• Bleeding
• Dark brown urine
• Muscle ache without an obvious cause, such as exercise or injury
• Muscle rigidity and stiffness
• Quick rise in body temperature to 105 degrees F or higher

Who is at highest risk?[edit | edit source]

Malignant hyperthermia is inherited. Only one parent has to carry the disease for a child to inherit the condition.

It may occur with muscle diseases such as multiminicore myopathy and central core disease.

When to seek urgent medical care?[edit | edit source]

Tell both the surgeon and anesthesiologist before having any surgery if:

• You know that you or a member of your family has had problems with general anesthesia
• You know you have a family history of malignant hyperthermia

Diagnosis[edit | edit source]

Malignant hyperthermia is often discovered after a patient is given anesthesia during surgery.

There may be a family history of malignant hyperthermia or unexplained death during anesthesia.

The person may have a fast and often irregular heart rate.

Tests that may be done include:

• Chem-20
• Genetic testing to look for defects in the RYR1 gene
• Muscle biopsy
• Urine myoglobin (muscle protein) determination

Treatment options[edit | edit source]

During an episode of malignant hyperthermia, wrapping the patient in a cooling blanket can help reduce fever and the risk of serious complications. Drugs such as dantrolene, lidocaine, or a beta-blocker drug can help with heart rhythm problems.

To preserve kidney function during an episode, you must get fluids through a vein and by mouth, as well as certain medications.

Where to find medical care for Malignant hyperthermia?[edit | edit source]

Directions to Hospitals Treating Malignant hyperthermia

What to expect (Outlook/Prognosis)?[edit | edit source]

Repeated episodes or untreated episodes can cause kidney failure. Untreated episodes can be fatal.

Possible complications[edit | edit source]

• Amputation
• Breakdown of muscle tissue (rhabdomyolysis)
• Compartment syndrome (swelling of the hands and feet and problems with blood flow and nerve function)
• Death
• Disseminating intravascular coagulation (abnormal blood clotting and bleeding)
• Heart rhythm problems
• Kidney failure
• Metabolic acidosis
• Respiratory dysfunction (fluid buildup in the lungs)
• Weak muscles (myopathy) or muscular dystrophy (deformity)

Prevention[edit | edit source]

If you or anyone in your family has malignant hyperthermia it is very important to tell your doctor, especially before having surgery with general anesthetia. Using certain medications can prevent the complications of malignant hyperthermia during surgery.

Avoid stimulant drugs such as cocaine, amphetamine (speed), and ecstasy. These drugs may cause problems similar to malignant hyperthermia in people who are prone to this condition.

Genetic counseling is recommended for anyone with a family history of myopathy, muscular dystrophy, or malignant hyperthermia.

Sources[edit | edit source]

http://www.nlm.nih.gov/medlineplus/ency/article/001315.htm

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