{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T04:30:15Z","timestamp":1762144215714},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2003,7,23]],"date-time":"2003-07-23T00:00:00Z","timestamp":1058918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Malignant hyperthermia (MH) is a metabolic myopathy with an abnormal release of calcium by the sarcoplasmic reticulum (SR), triggered by volatile anesthetics and succinylcholine. Similarly, caffeine enhances Ca<jats:sup>2+<\/jats:sup>release by the SR in vitro. In a prospective, randomized study, high\u2010energy phosphates were studied by intramuscular 31\u2010phosphorus magnetic resonance spectroscopy (<jats:sup>31<\/jats:sup>P\u2010MRS) in 10 MH\u2010susceptible (MHS) and 7 MH\u2010nonsusceptible (MHN) subjects before and after injection of 0.5 ml caffeine (20 mM). Intramuscular energy balance, measured by the ratios of P<jats:sub>i<\/jats:sub>\/PCr and P<jats:sub>i<\/jats:sub>\/\u03b3\u2010ATP, did not differ between MHS and MHN patients before and after intramuscular caffeine injection. However, within each group, P<jats:sub>i<\/jats:sub>\/PCr and P<jats:sub>i<\/jats:sub>\/\u03b3\u2010ATP increased significantly only in the MHS group. Intramuscular caffeine injection seemed to impair the metabolic balance in MHS individuals. This may reflect a local calcium overload leading to consumption of high\u2010energy phosphates and increase of inorganic phosphate. Intramuscular stimulation by caffeine and <jats:sup>31<\/jats:sup>P\u2010MRS may provide a valuable tool to investigate MH\u2010related metabolic disturbances. 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