Snake envenomation and malignant hyperthermia.

TYSON Paul Paul.Tyson at CardiffandVale.wales.nhs.uk
Thu Dec 9 22:16:46 EST 2004


Malignant hyperpyrexia is a genetically determined predisposition, in which susceptible individuals develop symptoms of pyrexia, rhabdmyolysis, spasm and muscle fasciculation in response to volatile halogen anaesthetics (halothane) and neuromuscular-blocking agents (Suxamethonium.). Susceptible individuals appear to have mutations in ryanodine receptor genes, as well as altered distribution of ion-channels (Na, Ca, K) throughout muscle / sarcoplasmic reticulum.

In theory, snakebites containing neurotoxins that act postsynaptically like Suxamethonium could precipitate the malignant hyperpyrexia in susceptible individuals. However there are no cases in the literature as far as I have found. Has anyone ever come across this before, or heard of a case, and would anyone care to comment on whether such patients would be more at risk from the envenomation itself rather than the hyperpyyrexia?
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