Muscle contraction
Fever
May have dark colored urine from myoglobinuria
First signs
Hypercarbia
Sinus tachycardia
Masseter spasm
Temperature abnormalities (may be early)
Most common pattern
Respiratory acidosis and muscular abnormalities
Hypercarbia
Sinus tachycardia
Masseter spasm
Temperature abnormalities (may be early)
Respiratory acidosis and muscular abnormalities
99% Respiratory Acidosis
26% Metabolic Acidosis
80% Muscular Abnormalities
Watch for it with succinylcholine use.
Fulminant<unk> 
muscle rigidity, high fever, increased HR shortly after induction of anesthesia
Masseter muscle rigidity
jaw muscle rigidity after succinylchoine
More common in children
Presages<unk>  in 20-30% cases
All patients demonstrate elevated CK and often gross myoglobinuria
CK >20,000IU = high likelihood of<unk> 
Late onset<unk> 
Uncommon, may begin shortly after anesthesia termination (usually within first hour)
muscle rigidity, high fever, increased HR shortly after induction of anesthesia
jaw muscle rigidity after succinylchoine
More common in children
Presages<unk>  in 20-30% cases
All patients demonstrate elevated CK and often gross myoglobinuria
CK >20,000IU = high likelihood of<unk> 
Uncommon, may begin shortly after anesthesia termination (usually within first hour)
Malignant hyperthermia
Infectious
Nitrogen narcosis
Sepsis
CO2 narcosis
Meningitis
Spinal shock
Encephalitis