A Case Report of an Incidental Ultrasound Finding in a Suspected Malignant Hyperthermia Patient.

IF 0.5 A&A Practice Pub Date : 2022-12-01 DOI:10.1213/XAA.0000000000001651
Pei-Han Fu, Chun-Ning Ho
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Abstract

Malignant hyperthermia (MH) is a rare but life-threatening genetic disorder of the skeletal muscles triggered by inhalation anesthetics or succinylcholine. A 49-year-old female developed symptoms of MH shortly after a lumbar surgery. Despite being insidious, MH was diagnosed based on the clinical grading scale. We incidentally discovered fine fasciculations in extremities while inserting an ultrasound-guided arterial catheter. On receiving dantrolene, her symptoms improved within 20 minutes; a subsequent ultrasound revealed no fasciculations. Although halothane contracture testing was not available, the fasciculations that resolved with dantrolene administration in a MH suspected patient opens up a new potential avenue of diagnostics.

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疑似恶性高热病人的偶然超声发现一例报告。
恶性高热症(MH)是一种罕见但危及生命的骨骼肌遗传疾病,由吸入麻醉剂或琥珀胆碱引发。一名49岁女性在腰椎手术后不久出现MH症状。尽管是隐匿的,但MH是根据临床分级量表诊断的。在插入超声引导的动脉导管时,我们偶然发现了四肢的细束。服用丹曲林后,患者症状在20分钟内改善;随后的超声检查未见束状搏动。虽然没有氟烷挛缩试验,但在MH疑似患者中使用丹曲林解决了肌束痉挛,为诊断开辟了新的潜在途径。
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A&A Practice
A&A Practice ANESTHESIOLOGY-
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期刊介绍: A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.
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