Thursday, August 9, 2018

Malignant Hyperthermia and Neuroleptic malignant syndrome

Q: Which of the following statement(s) is/are true? (Select one)

A) Malignant Hyperthermia (MH) in the postoperative period is extremely rare
B) Neuroleptic malignant syndrome (NMS) is usually of slow onset
C) Usually, clinical signs of MH occurs within one hour of anesthesia induction
D) NMS usually does not occur during administration of general anesthesia
E) All of the above

Answer: E

The objective of the above question is to highlight the major differentiating point between MH and NMS in view of their timings. MH is extremely rare in the postoperative period. Although it usually occurs within one hour of anesthesia induction but can occur any time during anesthesia due to triggering agent. In contrast, NMS may take up to 72 hours to clearly manifest and practically never occurs during administration of general anesthesia.



1. Velamoor VR, Norman RM, Caroff SN, et al. Progression of symptoms in neuroleptic malignant syndrome. J Nerv Ment Dis 1994; 182:168.

2.  Larach MG, Gronert GA, Allen GC, et al. Clinical presentation, treatment, and complications of malignant hyperthermia in North America from 1987 to 2006. Anesth Analg 2010; 110:498.

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