A 22-year-old man with mental disabilities with the history of neuroleptic malignant syndrome and heat stroke was scheduled for dental treatment under general anesthesia. Heat stroke and neuroleptic malignant syndrome are related to malignant hyperthermia. We suggested the patient and family to undergo preoperative screening tests for malignant hyperthermia susceptibility, but they rejected. We selected slow induction using nitrous oxide, oxygen and sevoflurane to prevent excitement and anxiety for placing a catheter in a peripheral vein. We were very cautious in primary symptoms of malignant hyperthermia, i.e., tachycardia, increased end-tidal carbon dioxide, and rigidity of masseter. In the perioperative period, no complications occurred.
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