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Alternative names
Hyperthermia - malignant; Hyperpyrexia - malignantDefinition Return to top
Malignant hyperthermia is a group of inherited muscle problems characterized by muscle breakdown following certain stimuli -- such as anesthesia, extremes of exercise (particularly in hot conditions), fever, or use of stimulant drugs. The problems associated with this condition result from over-excitable muscles that contract uncontrollably, severe fever, abnormal heart rhythms, and kidney failure.Causes, incidence, and risk factors Return to top
Malignant hyperthermia is inherited as an autosomal dominant trait (it requires only one affected parent for a child inherit the condition). It may be associated with muscular diseases such as muscular dystrophy and central core disease.
Malignant hyperthermia is often noted for the first time during administration of anesthesia. The anesthetized patient rapidly develops a high fever and muscle rigidity. During these episodes, muscle tissue is destroyed and break-down products of muscle may damage the kidneys and cause acute renal failure. The urine may turn dark due to released muscle pigments (see rhabdomyolysis).
Malignant hyperthermia can be fatal if not treated immediately. It can be prevented by administration of appropriate drugs before anesthesia.
Symptoms Return to top
Signs and tests Return to top
Treatment Return to top
The best course of action for this condition is prevention. If a general anesthetic is to be given, pretreatment with dantrolene sodium is recommended. If you have a family history of anesthesia-induced problems it is imperative to alert your surgeon and anesthesiologist.Expectations (prognosis) Return to top
Episodes of the disorder can often be prevented. Repeated episodes or untreated episodes can cause kidney failure. Untreated episodes can be fatal. Fortunately, the use of the drug dantrolene has made fatalities much less common.Complications Return to top
Calling your health care provider Return to top
If you know that you or a member of your family has had problems with general anesthesia, or if you know you have a family history of malignant hyperthermia, be sure to notify both the surgeon and the anesthesiologist before having any surgery.Prevention Return to top
It is important to recognize susceptible patients before giving them anesthesia. Clues may be obtained from the family history or previous episodes. Episodes of malignant hyperthermia may be prevented by giving dantrolene sodium before anesthesia.
It is important to avoid stimulant drugs such as cocaine, amphetamine (speed) and ecstasy (an amphetamine derivative) as they may produce malignant hyperthermia-like problems in susceptible individuals.
Genetic counseling is recommended for anyone with a family history of myopathy, muscular dystrophy or malignant hyperthermia.
Update Date: 8/19/2003 Updated by: Douglas R. Stewart, M.D., Division of Medical Genetics, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |