Malignant hyperthermia

Malignant hyperthermia (MH), a potentially fatal hypermetabolic reaction, is a genetic disorder of skeletal muscle.(1-8) The triggers for the hypermetabolic reaction are some anesthetics and muscle relaxants, or extreme stress in the form of heat or exercise.(4-6) If recognized early the MH reaction can be reversed by the administration of dantrolene, a muscle relaxant, in addition to medical treatment such as cooling and hyperventilation.(1) Unfortunately, by the time the condition is recognized, the individual may have experienced extensive muscle damage (rhabdomyolysis) due to sustained muscle rigidity(9) and, therefore, have muscle pain and weakness and decreased range of motion (ROM) in the affected extremities.(10) Physical therapists may encounter clients with MH in a variety of settings such as on sports fields, in the clinic, and in intensive care units. Understanding the etiology, pathophysiology, clinical presentation, and medical management of MH should provide the basis for physical therapy management of this complicated and intriguing disorder. There is a paucity of literature, however, regarding physical therapy treatment of MH. The purpose of this article is to increase awareness for physical therapy practitioners about MH in susceptible clients.