Malignant hyperthermia : Malignant hyperthermia is disease passed down through families that causes a fast rise in body temperature (fever) and severe muscle contractions when the affected person gets general anesthesia. This condition is not the same as hyperthermia that is due to medical emergencies such as heat stroke or infection. Malignant hyperthermia is inherited. Only one parent has to carry the disease for a child to inherit the condition.
Malignant hyperthermia is a severe reaction to a dose of anesthetics. The reaction is sometimes fatal. It is caused by a rare, inherited muscle abnormality. Infrequently, extreme exercise or heat stroke can trigger malignant hyperthermia in someone with the muscle abnormality.
It may occur with muscle diseases such as multiminicore myopathy and central core disease (autosomal dominant).
Symptoms
Symptoms include:
• Bleeding
• Dark brown urine
• Muscle ache without an obvious cause, such as exercise or injury
• Muscle rigidity and stiffness
• Quick rise in body temperature to 105 degrees F or higher
Treatment
During an episode of malignant hyperthermia, wrapping the patient in a cooling blanket can help reduce fever and the risk of serious complications. Drugs such as dantrolene, lidocaine, or a beta-blocker drug can help with heart rhythm problems. Dantrolene relaxes the muscles. It stops the dangerous increase in muscle metabolism.
Dantrolene is given intravenously until a patient has stabilized. Then, the medication typically is continued in pill form for three days.
Additional treatment can include:
• Lowering body temperature with:
o Cool mist and fans
o Cooling blankets
o Cooled intravenous fluids
• Administering oxygen
• Using medications to:
o Control the heartbeat
o Stabilize blood pressure
Spasticity : Spasticity is stiff or rigid muscles. It may also be called unusual tightness or increased muscle tone. Reflexes (for example, a knee-jerk reflex) are stronger or exaggerated. The condition can interfere with walking, movement, or speech.
Symptoms
Episodes of spasticity can range from very mild to debilitating and painful. Signs of spasticity include:
• muscle tightness
• joint stiffness
• involuntary jerky movements
• exaggeration of reflexes
• unusual posture
• abnormal positioning of fingers, wrists, arms, or shoulders
• muscle spasms
• involuntary crossing of the legs (this is called "scissoring" because the legs cross like the tip of a pair of scissors)
• difficulty controlling the muscles used to speak
• muscle contraction that limits your range of motion or prevents your joints from extending all the way
• pain in the affected muscles and joints
• back pain
• difficulty moving
Spasticity can be triggered when you change position or move suddenly. Other spasm triggers include high humidity, extreme heat, extreme cold, infection, and clothing that is too tight.
Causes of Spasticity
The main cause of spasticity is damage to the nerve pathways that control the movement of muscles. This can be a symptom of a variety of conditions and diseases, including:
• brain injury
• spinal cord injury
• stroke
• cerebral palsy
• multiple sclerosis (MS)
• amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease)
• hereditary spastic paraplegias
• adrenoleukodystrophy
• phenylketonuria
• Krabbe disease
Medication
• Medical interventions may include such medications as baclofen, diazepam, dantrolene, or clonazepam. Phenol injections can be used, or botulinum toxin injections into the muscle belly, to attempt to dampen the signals between nerve and muscle.