Malignant hyperpyrexia is a highly lethal complication of general anesthesia. It occurs with sufficient frequency, particularly in children and young adults, to justify use of continuous temperature monitoring during adminnstration of general anesthesia. Fever may be a late manifestation of the malignant hyperpyrexia syndrome, and it is important to be aware of the early signs. Prompt recognition and aggressive management should lower the high mortality known to occur with this complication. Family members should be screened for CPK elevations to determine possible susceptibility to malignant hyperpyrexia. Two case reports illustrate these points of diagnosis and management.
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http://dx.doi.org/10.1016/0022-3468(76)90285-2 | DOI Listing |
Anesthesiology
February 2025
The North American Malignant Hyperthermia Registry of the Malignant Hyperthermia Association of the United States, Sherburne, New York (M.G.L.).
A A Pract
January 2025
From the Department of Anesthesiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
Malignant hyperthermia (MH) is a rare genetic disorder triggered by inhalational anesthetics or depolarizing neuromuscular blocking agents that carries significant mortality if not promptly treated. The following case presents a healthy 39-year-old man who developed MH several hours into an anesthetic exposure. Rapid intraoperative stabilization tactics that paralleled intensive care unit (ICU) level care allowed for continuation of operative management as opposed to case termination given the patient was at high risk for permanent nerve palsy if the case were to be aborted during dissection.
View Article and Find Full Text PDFClin Case Rep
January 2025
Craig R Dufresne Fairfax Virginia USA.
Freeman-Burian syndrome is a rare craniofacial syndrome surrounded by fake news. This situation shows the strong connection between the quality of a literature search and clinical reasoning displayed in patient care, especially in care of patients with rare conditions.
View Article and Find Full Text PDFJ Acad Consult Liaison Psychiatry
January 2025
Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA, 33613; Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, 32608.
Background: Neuroleptic malignant syndrome (NMS) is a rare yet potentially fatal iatrogenic syndrome that can manifest with life-threatening symptoms. Theorized to be caused by the dopamine-blocking effects of certain medications, such as antipsychotics, or the withdrawal of dopaminergic agents, NMS is characterized by hyperthermia, autonomic instability, altered mental status, and muscular rigidity. Most treated cases resolve within weeks; however, in some cases, residual catatonic symptoms can persist for months after the resolution of acute hyperthermic and hypermetabolic symptoms.
View Article and Find Full Text PDFCatatonia is one of the most severe psychiatric syndromes, and clinical symptoms and etiology are very heterogeneous. When accompanied by autonomic instability and hyperthermia it’s termed malignant catatonia, which left untreated is associated with significant morbidity and mortality. First-line treatment is high dose benzodiazepines, followed by electroconvulsive therapy (ECT), in case of non-response.
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