Muscle Biopsy testing:
Who should be tested for Malignant Hyperthermia (MH)?
All individuals who experienced a MH-crisis or likely MH-crisis during a general anesthetic with triggering agents. Individuals in whom a close relative experienced a MH-crisis or likely crisis or has been found to MH-susceptible after testing.
How reliable is the muscle biopsy testing?
In general, this test is very reliable and is currently the only way to test for MH-susceptibility. Since no test can ever be perfect, this test is designed to err on the side of caution. That means it is very unlikely to miss a MH-susceptible patient with this test. However, in some rare cases the test may turn out positive even though the patient is not truly MH-susceptible.
Is there no simpler test than a muscle biopsy?
No. Unfortunately there is no alternative test available at this time. Since MH-susceptibility is an inherited condition, researchers hope to develop a blood test for genetic testing in the future. However, if you have been advised to be tested, you should not delay having a muscle biopsy because any "simpler" test is likely years away from today.
Does a muscle biopsy under anesthesia put me at risk for a MH-crisis?
No. You will be treated as if you were MH-susceptible, so triggering agents will be avoided. At our institution patients coming for biopsy most commonly receive a general anesthetic with non-triggering agents. Other safe alternatives are regional anesthesia or nerve blocks and spinal/epidural anesthesia. The biopsy itself is a minor surgical procedure that takes usually not more than 30 minutes to perform. Most patients will be able to return home the same day.
How extensive is the surgery for muscle biopsy?
The muscle biopsy is a minor surgical procedure where an incision (1-2 inches long) is made on the mid thigh. In most cases this will result only in a small scar.
Do I have to stay in the hospital for a muscle biopsy?
Unless patients have other significant medical problems, they are usually able to return home the same day. If the patient is a child, most institutions would probably let the child return home and advise the parents to stay within a close distance to the hospital.
How soon will I have my test results?
Test results from the muscle biopsy are usually available on the day of the biopsy, so that they can be discussed with the patient before he/she returns home.
Can children be tested?
Yes, children can be tested as safely as adults. Anesthesia is usually given through an intravenous line that is started before the case. However, most centers will not test children smaller than 40 pounds of body weight to avoid disfiguring scars.
Who performs muscle biopsies?
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United States |
Uniformed Services University of the Health Sciences
Bethesda, MD 20014
(military personnel/civilians of greater Washington area)
Sheila Muldoon, MD
(301) 295 3140
University of California
Davis, CA 95616
Timothy Tautz, MD
(530) 752 7805
University of California
Los Angeles, CA 90024
Jordan D. Miller, MD
(310) 825 7850
Wake Forest University Baptist Medical Center
Winston-Salem, NC 27157
Joseph R. Tobin, MD
(336) 716 4498
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Canada |
Toronto General Hospital
Toronto, Ontario
Julian Loke, MD, FRCPC
(416) 340 3128
Ottawa Civic Hospital
Ottawa, Ontario
Gordon Reid, MD, FRCPC
(613) 761 4169 |
Who covers the costs for MH-testing?
The costs for muscle biopsy testing amount to about $2,500.
Most insurance companies in the US will cover these costs in full or at least partially.
If your insurance company does not provide coverage, contact one of the institutions that performs muscle biopsies to explore other ways of financing.
What if I need (emergency) surgery before I can get tested?
First of all, tell your physicians, especially your anesthesiologist, that you may be MH-susceptible but have not yet been tested.
Also, tell your family and significant others so that everyone is informed.
Anesthesia can be safely administered in an emergency situation by avoiding triggering agents. But unless a surgical procedure needs to be performed urgently, many experts would rather postpone surgery until a muscle biopsy has been performed.