Regular updates by our President, MHAUS staff, and guest contributors.
A few months ago, I received an unusual call from the MH Hotline who connected me to an anesthesiologist and OR team who were desperately trying to manage a Malignant Hyperthermia crisis. They were frantic and clearly trying to stabilize a patient experiencing a severe MH episode. The patient was an athletic older teenager undergoing an elective orthopedic surgical procedure on the ankle. Anesthesia was being conducted with the commonly used gas anesthetic sevoflurane and Succinylcholine had not been used.
The World Congress of Anesthesia is a meeting of anesthesiologists representing many countries that convenes in a different country every four years.
In the episode, the young patient undergoing emergency surgery develops elevated levels of carbon dioxide, increased heart rate and elevated temperature. The anesthesiologist recognizes the signs and informs the team of the problem. One of the OR personnel is dispatched to obtain ice and the anesthesiologist whips out a vial of dantrolene, injects it and waits for the signs of MH to respond.
At this joyous time of the year, I would like to wish all the friends and supporters of MHAUS best wishes for the holidays and the New Year. Your support and encouragement of our activities and programs motivates the entire team to continue to bring the latest information and educational programs to those with an interest in this complex, potentially fatal disorder first described over 50 years ago.
From the beginning descriptions of the MH syndrome in the 1960s it was noted that the animal model for MH, i.e. certain pig breeds would develop muscle breakdown, acidosis, and high body temperature with stress alone (“awake MH”, i.e. MH signs without exposure to anesthetic agents).
1981 was a rather important year in my professional life. On July first I assumed the Chairmanship of Anesthesiology at Hahnemann University in Philadelphia. In October 1981 the first meeting of what would turn out to be the founding Board of MHAUS met in my unfinished offices at Hahnemann. It is hard to believe that thirty years have gone by which witnessed the evolution of a patient advocacy organization from an unknown entity to one where anyone seeking information and guidance on MH turns first.
Surprising revelations concerning the association of MH with Drug induced muscle pain; muscle weakness with age; and an inherited syndrome of muscle weakness.
In this month’s blog, I have asked Dr. Stanley Caroff, Professor of Psychiatry at the University of Pennsylvania, a long time member of MHAUS and prolific author on the subject of Neuroleptic Malignant Syndrome (NMS) to summarize several drug related reactions that resemble MH in some ways but are generally thought to be unrelated to the mechanisms that lead to MH.
When an MH susceptible patient requires a general anesthetic one concern is whether he/she will be inadvertently exposed to potent gas anesthetics such as sevoflurane or isoflurane that may trigger an MH episode.