To the Editor: We were interested in the review of the neuroleptic malignant syndrome by Guzé and Baxter (July 18 issue).1 However, as anesthesiologists we were rather perturbed by the suggestion that pancuronium or curare should be used to help distinguish malignant hyperthermia from it. This is not an accepted diagnostic maneuver in malignant hyperthermia. When the diagnosis of malignant hyperthermia is suspected (the main clue being that it usually occurs perioperatively in association with the administration of certain anesthetic drugs), it is immediately treated as such before it becomes fulminant. This consists of stopping volatile anesthetic agents, giving intravenous.
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