Malignant Hyperthermia

  • Julia R. Menshenina
  • Suzanne K. W. MankowitzEmail author


Malignant hyperthermia is a hypermetabolic crisis of unregulated calcium accumulation and muscle activation in response to halogenated volatile anesthetics and succinylcholine. It is most frequently caused by mutations in the ryanodine receptor, a calcium channel in the sarcoplasmic reticulum of myocytes. Symptoms include masseter muscle spasm, generalized muscle rigidity, hypercarbia, a mixed metabolic and respiratory acidosis, hyperthermia, hyperkalemia, rhabdomyolysis, myoglobinuria, arrhythmias, and cardiovascular collapse. Management consists of dantrolene, supportive care, and avoidance of triggers. The gold standard test is the caffeine halothane contracture test. Genetic testing is possible, but not all mutations are known. Parturients who are susceptible to MH or whose fetuses may be susceptible to MH should receive regional anesthesia or non-triggering anesthetics if general anesthesia is required.


Malignant hyperthermia Dantrolene Masseter muscle rigidity Masseter spasm Ryanodine receptor 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Julia R. Menshenina
    • 1
  • Suzanne K. W. Mankowitz
    • 2
    Email author
  1. 1.California Pacific Medical CenterSan FranciscoUSA
  2. 2.Department of AnesthesiologyColumbia University Medical CenterNew YorkUSA

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