Clinical presentation of malignant hyperthermia

It is important to be aware of the different modes of presentation of malignant hyperthermia in order to be alert to the potential diagnosis. An attempt has been made to score the various modalities so as to give the likelihood of malignant hyperthermia ( L.a.ra.chLeL§.L 19.94). However, this method is very limited, particularly when data are missing, and no allowance is made for grading either the severity or the timing of the clinical signs.

In a previous study (Ellis eta!, 1990), the various modes of clinical presentation of malignant hyperthermia were divided into eight groups ranging from the full-blown life-threatening fulminant case to a simple postoperative pyrexia. The results of in vitro contracture tests showed a good correlation with the eight categories such that, given a clinical scenario, the likelihood of malignant hyperthermia could be predicted ( Table 1). The drawback of this method is that it depends entirely on the diligence and skill of the anesthetist interpreting the clinical situation and requires full documentation of all the clinical events.


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Table 1 The likelihood of malignant hyperthermia according to type of clinical presentation

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