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In most people with malignant hyperthermia susceptibility, they have few or no symptoms unless they are exposed to a triggering agent. The most common triggering agents are volatile anesthetic gases, such as halothane , sevoflurane , desflurane , isoflurane , enflurane or the depolarizing muscle relaxants suxamethonium and decamethonium used ...
The primary treatment strategy is to eliminate or discontinue the offensive agent. Supportive therapy, such as ice packs, may be provided to get the body temperature within physiologic range. In severe cases, when the fever is high enough (generally at or above ~104°F or 40°C), aggressive cooling such as an ice bath and pharmacologic therapy ...
Recreational drugs such as amphetamines [17] and cocaine, [18] PCP, dextromethorphan, LSD, and MDMA may cause hyperthermia. [2] Malignant hyperthermia is a rare reaction to common anesthetic agents (such as halothane) or the paralytic agent succinylcholine. Those who have this reaction, which is potentially fatal, have a genetic predisposition. [2]
Halothane sensitises the heart to catecholamines, so it is liable to cause cardiac arrhythmia, occasionally fatal, particularly if hypercapnia has been allowed to develop. This seems to be especially problematic in dental anesthesia. [25] Like all the potent inhalational anaesthetic agents, it is a potent trigger for malignant hyperthermia. [5]
Dantrolene was widely used in the management of spasticity [19] before its efficacy in treating malignant hyperthermia was discovered by South African anesthesiologist Gaisford Harrison and reported in a landmark 1975 article published in the British Journal of Anaesthesia. [20]
The diagnosis is suggested on patients with a history of drug exposure to the most common inducing agents such as strong antidopaminergic medications. [6] [40] The differential diagnosis includes serotonin syndrome, [41] encephalitis, toxic encephalopathy, status epilepticus, heat stroke, catatonia and malignant hyperthermia.
Hyperthermia therapy (or hyperthermia, or thermotherapy) is a type of medical treatment in which body tissue is exposed to temperatures above body temperature, in the region of 40–45 °C (104–113 °F). Hyperthermia is usually applied as an adjuvant to radiotherapy or chemotherapy, to which it works as a sensitizer, in an effort to treat cancer.
RyR1 mutations are associated with malignant hyperthermia and central core disease. [17] Mutant-type RyR1 receptors exposed to volatile anesthetics or other triggering agents can display an increased affinity for cytoplasmic Ca 2+ at activating sites as well as a decreased cytoplasmic Ca 2+ affinity at inhibitory sites. [18]