Malignant Hyperthermia Like Manifestations during Management of Refractory Status Epilepticus

Abstract

Management of refractory status epilepticus is challenging for a neurointensivist consequent to systemic complexities associated with various drugs and modalities involved in its treatment. We report one such case that manifested with multiple signs of malignant hyperthermia following use of isoflurane to control seizures. However, the delayed and random occurrence of the signs and negative genetic test report raises doubts regarding the final diagnosis. Delayed presentation of malignant hyperthermia has been reported earlier. Unavailability of dantrolene sodium handily is a major hurdle in treating such cases. We enumerate management of the patient in our intensive care unit.

Keywords

• status epilepticus
• malignant hyperthermia
• delayed malignant hyperthermia
• isoflurane