European Malignant Hyperthermia Group guidelines for investigation of malignant hyperthermia susceptibility

Br J Anaesth. 2015 Oct;115(4):531-9. doi: 10.1093/bja/aev225. Epub 2015 Jul 18.


It is 30 yr since the British Journal of Anaesthesia published the first consensus protocol for the laboratory diagnosis of malignant hyperthermia susceptibility from the European Malignant Hyperthermia Group. This has subsequently been used in more than 10 000 individuals worldwide to inform use of anaesthetic drugs in these patients with increased risk of developing malignant hyperthermia during general anaesthesia, representing an early and successful example of stratified medicine. In 2001, our group also published a guideline for the use of DNA-based screening of malignant hyperthermia susceptibility. We now present an updated and complete guideline for the diagnostic pathway for patients potentially at increased risk of developing malignant hyperthermia. We introduce the new guideline with a narrative commentary that describes its development, the changes to previously published protocols and guidelines, and new sections, including recommendations for patient referral criteria and clinical interpretation of laboratory findings.

Keywords: CACNA1S; RYR1; excitation–contraction coupling; malignant hyperthermia; malignant hyperthermia susceptibility, diagnosis; skeletal muscle.

Publication types

  • Practice Guideline

MeSH terms

  • Europe
  • Genetic Predisposition to Disease
  • Humans
  • Malignant Hyperthermia / diagnosis*
  • Malignant Hyperthermia / genetics*
  • Referral and Consultation