Malignant hyperthermia (MH) is a chemically induced, genetic myopathy characterized by metabolic and respiratory acidosis, arrhythmias, hyperpyrexia, and muscular rigidity usually occurring during or within 24 hours postanesthesia. It is initiated by some anesthetic drugs, muscle relaxants, and possibly by catecholamines produced by stress. The incidence of the disease is 1:15,000 in populations who have received a general anesthetic. A recently developed platelet bioassay test allows for rapid identification of the susceptible individual, while medication with dantrolene sodium can usually prevent or reverse the syndrome.
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http://dx.doi.org/10.1177/019459988108900602 | DOI Listing |
J 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.
View Article and Find Full Text PDFAnn Gen Psychiatry
January 2025
Faculty of Medicine, University of Belgrade, Belgrade, 11000, Serbia.
Background: Foreign language syndrome is a rare neuropsychiatric phenomenon typically following general anesthesia. To date, foreign language syndrome has not been associated with neuroleptic malignant syndrome (NMS) in the literature. This case aims to broaden the clinical understanding of NMS by presenting an atypical manifestation of foreign language syndrome and emphasizing the need for prompt recognition of such presentations for accurate diagnosis and management.
View Article and Find Full Text PDFPharmacogenet Genomics
February 2025
Department of Anesthesiology, Vanderbilt University Medical Center.
Objectives: We aimed to classify genetic variants in RYR1 and CACNA1S associated with malignant hyperthermia using biobank genotyping data in patients exposed to triggering anesthetics without malignant hyperthermia phenotype.
Methods: We identified individuals who underwent surgery and were exposed to triggering anesthetics without malignant hyperthermia phenotype and who had RYR1 or CACNA1S genotyping data available in our biobank. We classified all variants in the cohort using a Bayesian framework of the American College of Medical Genetics and Genomics and the Association of Molecular Pathologists guidelines for variant classification and updated the posterior probabilities from this model with the new information from our biobank cohort.
ACS Appl Mater Interfaces
January 2025
Clinical Biochemistry, Drug Delivery & Therapy (CB-DDT), Vall d'Hebron Institute of Research (VHIR), 08035 Barcelona, Spain.
Pancreatic ductal adenocarcinoma (PDAC) is a very challenging disease with a very poor prognosis. It is characterized by a dense desmoplastic stroma that hampers drug penetration and limits the effectiveness of conventional chemotherapy (CT). As an alternative, the combination of CT with hyperthermia (HT) has been proposed as an innovative treatment modality for PDAC.
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