Diagnosis
Identifying individuals at risk of a fulminant MH event prior to a procedure under general anesthesia can be challenging as many people with MH are asymptomatic and unaware of their condition. However, a significant clue to consider is the patient’s family history, as MH is an autosomal-dominant inherited disorder. To confirm the diagnosis, medical professionals may conduct a CHCT (caffeine-halothane contracture test) in North America or an IVCT (in vitro contracture test) in Europe. These tests involve taking a biopsy of the leg muscle and are typically performed at specialized MH diagnostic centers. In addition to these tests, genetic testing is also available as an option for diagnosis.
Treatment
When it comes to the treatment of fulminant MH, the key lies in the prompt identification and intervention by medical professionals. The first step is to immediately halt the administration of anesthesia and replace it with intravenous opiates and sedatives. In certain cases, nondepolarizing muscle relaxants may be used to continue anesthesia if necessary.
Researchers have made significant progress in identifying an antidote for anesthesia-induced fulminant MH. The affected individual is given 100% oxygen and the antidote is administered intravenously at five-minute intervals until their condition stabilizes.
Rapid treatment may lead to some side effects, including difficulty breathing, nausea, vomiting, headache, dizziness, and tissue death at injection sites if the injections are not administered correctly. However, it is important to note that these side effects are rare occurrences following intervention.