1/23. masseter muscle rigidity after vecuronium.masseter muscle rigidity after suxamethonium, usually occurring in children induced with halothane, is associated with malignant hyperthermia. A case is reported in which masseter muscle rigidity occurred in an adult following vecuronium. From the limited data available, this and two similar reported cases, it appears that non-depolarizing muscle relaxants can, very rarely, cause masseter muscle rigidity in adults. This masseter muscle rigidity may complicate airway management, but is unlikely to progress to generalized rigidity and malignant hyperthermia.- - - - - - - - - - ranking = 1keywords = hyperthermia (Clic here for more details about this article) |
2/23. Major symptoms and differential diagnosis of neuroleptic malignant syndrome: three case reports.The authors describe the cases of three patients presenting a major extrapyramidal symptom with rising CPK, inconstant hyperthermia and autonomic dysfunction. Through a brief review of the literature, the authors question the unity of the malignant syndrome. If hypertonia is quite constant, the rise in the seric CPK is aspecific and hyperthermia is inconstant.- - - - - - - - - - ranking = 1keywords = hyperthermia (Clic here for more details about this article) |
3/23. succinylcholine-induced masseter muscle rigidity during bronchoscopic removal of a tracheal foreign body.masseter muscle rigidity during general anesthesia is considered an early warning sign of a possible episode of malignant hyperthermia. The decision whether to continue or discontinue the procedure depends on the urgency of the surgery and severity of masseter muscle rigidity. Here, we describe a case of severe masseter muscle rigidity (jaw of steel) after succinylcholine (Sch) administration during general anesthetic management for rigid bronchoscopic removal of a tracheal foreign body. anesthesia was continued uneventfully with propofol infusion while all facilities were available to detect and treat malignant hyperthermia.- - - - - - - - - - ranking = 1keywords = hyperthermia (Clic here for more details about this article) |
4/23. Possible malignant neuroleptic syndrome that associated with hypothyroidism.A 54-year-old woman with schizophrenia presented to hospital with unconsciousness, fever and marked muscle rigidity. She had been given fluphenazine decanoete 20 mg intramuscularly 15 days before the admission and she had continued taking haloperidol 20 mg daily and oral biperiden 2-4 mg. She was extremely rigid and unresponsive. On laboratory investigations revealed: serum sodium 120 mEq/l, creatinine phosphokinase 12,980 IU/l (normal up to 170), lactate dehydrogenase 1544 IU/l (150-500), free trioidothyronine < 1.00 pg/ml (1.5-4.5), free throxyine 0.76 ng/dl (0.8-1.9), thyroid stimulating hormone 1.14 microU/ml (0.4-4), cortisol (at 8.00 a.m.) 9 microg/dl (5-25). Antipsychotic drugs were withdrawn after admission. A diagnosis of secondary adrenal insufficiency and secondary hypothyroidism was made. Hormonal substitution with hydrocortisone and levothyroxine and correction of hyponatremia with intravenous hypertonic saline solution resulted in rapid improvement of symptoms and signs. It seems that the symptoms and signs of hypothyroidism and hyponatremia were attributed to acute psychosis in this patient. As a conclusion failure to recognize the endocrinopathy may not only produce recovery difficulties but also psychiatric and endocrine repercussions if psychotropic medications are given in such masked cases.- - - - - - - - - - ranking = 6.213416929757E-5keywords = fever (Clic here for more details about this article) |
5/23. Paroxysmal sympathetic storm.INTRODUCTION: Paroxysmal sympathetic storm (PSS) is a rare syndrome characterized by episodic hypertension, hyperhydrosis, hyperthermia, tachycardia, tachypnea, and extensor posturing. case reports: This article describes two cases of PSS: one following traumatic brain injury and the other following cardiac arrest. DISCUSSION: The first responded to labetalol, morphine, and codeine, whereas the second responded to labetalol. CONCLUSION: These observations underscore the importance of central opioid receptors and nonselective beta-adrenergic antagonists in modulating catecholamine pathways.- - - - - - - - - - ranking = 0.5keywords = hyperthermia (Clic here for more details about this article) |
6/23. catatonia causing permanent cognitive impairment: a case study.OBJECTIVE: We describe a case of psychogenic malignant catatonia resulting in permanent cognitive impairment. BACKGROUND: catatonia is a neuropsychiatric syndrome characterized by catalepsy, negativism, mutism, muscular rigidity, and mannerisms, often accompanied by autonomic instability and fever. Little is known about the long-term cognitive consequences of the syndrome. METHOD: Medical history includes neurologic examination, neuropsychological evaluation, electroencephalographic data, magnetic resonance imaging, sodium amytal interview, and treatment with electroconvulsive therapy. RESULTS: Selective deficits in executive function and an anterograde amnesia were evident a week post-ECT treatment and continued to be present at follow-up after 2 years and 8 months. CONCLUSION: The permanent cognitive impairments are considered in the context of catatonia as a frontal lobe syndrome.- - - - - - - - - - ranking = 6.213416929757E-5keywords = fever (Clic here for more details about this article) |
7/23. Repeat episodes of severe muscle rigidity in a child receiving sevoflurane.We report on a patient who developed two episodes of severe muscle rigidity, increased endtidal CO2 and increased creatine phosphate kinase associated with sevoflurane anesthesia. Dysrhythmias and hyperthermia were not observed and dantrolene was not administered. genetic testing for the 17 known mutations associated with malignant hyperthermia (MH) was negative. Although we cannot rule out MH or other neuromuscular diseases we suggest that this rare event may be a direct effect of sevoflurane.- - - - - - - - - - ranking = 1keywords = hyperthermia (Clic here for more details about this article) |
8/23. neuroleptic malignant syndrome: recognizing an unrecognized killer.NMS has been with us for years as an often unrecognized entity. nurses ask why there are "more of these cases" when what might be happening is that NMS is being discovered for what it is. There have been cases where the authors are convinced that the "pneumonia" or "urinary tract infection" was in fact a mild case of NMS that cleared. Probably some of the "sudden deaths" that have been reported in the past with neuroleptics are the results of undiagnosed NMS. Any patient with a fever, fluctuating vital signs, and signs of difficulty with moving should be considered as a possible case of NMS. All nurses and physicians need to be aware of the possibility, but those who work with psychiatric patients must not forget this potentially life-threatening problem.- - - - - - - - - - ranking = 6.213416929757E-5keywords = fever (Clic here for more details about this article) |
9/23. malignant hyperthermia in a black adolescent. A case report.malignant hyperthermia is a rare genetic abnormality which presents in the peri-anaesthetic period with tachycardia, hyperventilation, hyperthermia and acidosis. Untreated, the mortality rate is in excess of 80%. This syndrome is much less common in blacks than whites. A case of malignant hyperthermia in a black South African, in whom the reaction only became evident in the postoperative period, is reported. The case also presents several other unusual features.- - - - - - - - - - ranking = 3.5keywords = hyperthermia (Clic here for more details about this article) |
10/23. Reversal of prolonged postoperative muscle rigidity by dantrolene: a case report.The use of dantrolene to reverse severe unexplained postanaesthetic muscle rigidity in a previously "healthy" 13-year-old male is described. Anaesthesia was induced with thiopentone. After intubation with pancuronium, the patient had an entirely uneventful nitrous oxide, oxygen and halothane anaesthetic. Immediately following reversal of the relaxant, the patient developed generalized muscle tightness and rigidity involving the trunk and extremities. This was prolonged and severe enough to interfere with adequate ventilation. The patient also had a prolonged recovery from the anaesthetic. After ruling out malignant hyperthermia and some other causes of rigidity, a tentative diagnosis of myotonia was made. The symptoms responded to IV dantrolene in a total dose of 2.0 mg.kg-1. Further testing failed to establish a definite diagnosis. dantrolene could be a useful drug in treating such unexplained muscle rigidity.- - - - - - - - - - ranking = 0.5keywords = hyperthermia (Clic here for more details about this article) |
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