الفهرس 
Aetiology and Pathophysiology of Malignant HyperthermiaOnly 14 pages are availabe for public view
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Abstract
Malignant hyperthermia, which is called the nightmare syndrome of anesthesiologists, is an acute life-threatening syndrome. It is a subclinical myopathy that is unmasked upon exposure to the potent inhalational anesthetic agents and succinylcholine. Skeletal muscle acutely and unexpectedly increases its oxygen consumption and lactase production resulting in greater heat production, respiratory and metabolic acidosis, muscle rigidity, sympathetic stimulation, and increased cellular permeability.
Its exact mechanism is still being debated. The most accepted theory is that MH is caused by an inability to control calcium concentrations within the muscle fiber and that it may involve a generalized alteration in cellular or subcellular membrane permeability.
Close monitoring of patients especially in susceptible individuals should be carried on in order to detect MH as early as possible and to perform rapid interference to stop the process.
Diagnosis is based on the basis of extraordinary temperature and acid-base and muscle aberration. Specific treatment is the action of dantrolene on muscle calcium movements. Symptomatic treatment is by reversal of acid-base and temperature changes.
Evaluation of affected families is guided by movements of circulating creatine phosphokinase and by analysis of drug-induced contractures in muscle biopsy specimens. Either general or regional anesthesia is safe for patients susceptible to MH, provided that if a general technique is chosen, care is taken to specially prepare the anesthesia machine and to avoid all anesthetic trigger agents.
Challenges for the future include identification of the gene or genes responsible for MH and eludication of the mechanism that links exposure to the subsequent loss of calcium control. We hope that continuing research will reveal the answers to many of these mysteries, so that the next generation of anesthesiologists will consider the description and conquest of MH an interesting aspect of anesthesia history.