Malignant hyperthermia

Key Information

Appropriate Tests


Muscle biopsy. Screening with Creatine kinase is possible in some families, but false negatives may occur.

The definitive test is the caffeine-halothane contracture test, which is performed in only a few specialised centres.

Susceptibility for malignant hyperthermia is inherited as an autosomal dominant condition with incomplete penetrance. 

History of an uneventful anaesthetic does not exclude a subsequent attack.

Mutations may be present in the ryanodine receptor (RYR1) and CACNA1S genes.

Additional information about genetic tests may be available in RCPA Catalogue of Genetic Tests and Laboratories.



  • Central core disease
  • Duchenne/Becker muscular dystrophy
  • Periodic paralysis
  • Mitochondrial myopathy
  • Myotonia congenita


Acute episode: Muscle rigidity, tachycardia, rapid increase in body temperature.

Electrolytes (potassium), Creatine kinase, Urea, Creatinine, Myoglobin urine, Blood gas arterial.

See also Disseminated intravascular coagulation.

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