A 21-year-old man suffered from exertional heat stroke with impaired consciousness and rhabdomyolysis after strenuous physical exercise. Within two weeks the patient recovered completely without any specific therapy. Based on the symptoms and laboratory investigations, this episode suggested a moderate form of malignant hyperthermia. An in vitro contracture test was performed and a predisposition to malignant hyperthermia was diagnosed; other muscular diseases were excluded by histological examination. At present, the in vitro contracture test is the only method used to determine susceptibility to malignant hyperthermia and should be performed when the diagnosis is suggested on clinical grounds.
In this study 69% of the NMD patients were diagnosed as susceptible to MH with the IVCT. These results suggest, that NMD patients bear a high risk for MH. On the other hand, it has been discussed that in vitro contracture testing is not specific in NMD patients because skeletal muscle specimens from these patients have an elevated in vitro sensitivity. However, regarding our results and from a clinical point of view, patients with NMD should be treated like MHS individuals, unless they have undergone IVCT and were classified as MH-normal.
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