DOI: https://doi.org/10.36347/sjmcr.2025.v13i03.009

Pages: 372-377

Malignant hyperthermia (MH) is a rare but life-threatening pharmacogenetic disorder triggered by volatile anesthetics and depolarizing muscle relaxants in genetically susceptible individuals. This case report describes a MH crisis in a pediatric and maternal ICU setting at Hassan II University Hospital, Fès. The pathophysiology of MH involves excessive calcium release from the sarcoplasmic reticulum due to mutations in the ryanodine receptor (RYR1) gene, leading to uncontrolled hypermetabolism, muscle rigidity, and severe complications, including hypercapnia, hyperthermia, rhabdomyolysis, and cardiovascular instability. The early clinical sign: hypercapnia, tachycardia, and muscle rigidity warrant immediate recognition and prompt treatment with dantrolene to prevent mortality. Diagnosis relies on clinical presentation, genetic testing, and in vitro contracture testing. The case underscores the importance of perioperative vigilance, early diagnosis, and emergency preparedness in managing MH crises. Advances in molecular diagnostics have improved risk stratification, enabling preoperative identification of susceptible patients. Given the rarity of MH, continued medical education and protocol adherence are critical for anesthesiologists and intensivists. This report aims to enhance awareness and preparedness in anesthesia and critical care settings to mitigate the risks associated with this condition.