A Case Report of an Incidental Ultrasound Finding in a Suspected Malignant Hyperthermia Patient. 2022

Pei-Han Fu, and Chun-Ning Ho
From the Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.

Malignant hyperthermia (MH) is a rare but life-threatening genetic disorder of the skeletal muscles triggered by inhalation anesthetics or succinylcholine. A 49-year-old female developed symptoms of MH shortly after a lumbar surgery. Despite being insidious, MH was diagnosed based on the clinical grading scale. We incidentally discovered fine fasciculations in extremities while inserting an ultrasound-guided arterial catheter. On receiving dantrolene, her symptoms improved within 20 minutes; a subsequent ultrasound revealed no fasciculations. Although halothane contracture testing was not available, the fasciculations that resolved with dantrolene administration in a MH suspected patient opens up a new potential avenue of diagnostics.

UI MeSH Term Description Entries
D008305 Malignant Hyperthermia Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia. Hyperpyrexia, Malignant,Hyperthermia, Malignant,Malignant Hyperpyrexia,Anesthesia Related Hyperthermia,Hyperthermia of Anesthesia,Anesthesia Hyperthermia,Hyperthermia, Anesthesia Related,Malignant Hyperpyrexias
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003620 Dantrolene Skeletal muscle relaxant that acts by interfering with excitation-contraction coupling in the muscle fiber. It is used in spasticity and other neuromuscular abnormalities. Although the mechanism of action is probably not central, dantrolene is usually grouped with the central muscle relaxants. Dantrium,Dantrolene Sodium,Sodium, Dantrolene
D005260 Female Females
D006221 Halothane A nonflammable, halogenated, hydrocarbon anesthetic that provides relatively rapid induction with little or no excitement. Analgesia may not be adequate. NITROUS OXIDE is often given concomitantly. Because halothane may not produce sufficient muscle relaxation, supplemental neuromuscular blocking agents may be required. (From AMA Drug Evaluations Annual, 1994, p178) 1,1,1-Trifluoro-2-Chloro-2-Bromoethane,Fluothane,Ftorotan,Narcotan
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013390 Succinylcholine A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. Succinyldicholine,Suxamethonium,Anectine,Celocurine,Dicholine Succinate,Ditilin,Listenon,Lysthenon,Myorelaxin,Quelicin,Succicuran,Succinylcholine Chloride,Succinylcholine Dibromide,Succinylcholine Dichloride,Succinylcholine Dichloride, Di-H2O,Succinylcholine Diiodide,Succinylcholine Diperchlorate,Succinylcholine Iodide,Suxamethonium Bromide,Suxamethonium Chloride,Bromide, Suxamethonium,Dibromide, Succinylcholine,Dichloride, Succinylcholine,Diiodide, Succinylcholine,Diperchlorate, Succinylcholine,Succinate, Dicholine,Succinylcholine Dichloride, Di H2O
D018685 Anesthetics, Inhalation Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173) Inhalation Anesthetic,Inhalation Anesthetics,Anesthetic Gases,Anesthetic, Inhalation,Gases, Anesthetic

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