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Treatment of Heat Stroke

James P. Knochel, MD
JAMA. 1983;249(8):1006-1007. doi:10.1001/jama.1983.03330320014014.
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To the Editor.—  Two letters have appeared in The Journal recently (by Lydiatt and Hill entitled "Treatment of Heat Stroke by Dantrolene" [1981; 246:41] and by Meyers and Meyers entitled "Thermic Stress Syndrome" [1982;247:2098]) recommending that heat stroke patients receive dantrolene sodium intravenously as a specific treatment for hyperthermia. Lydiatt and Hill described a patient with heat stroke who allegedly responded favorably to dantrolene who had already been immersed in ice for 30 minutes. Meyers and Meyers reported no experience whatsoever, but they suggested that hyperthermia in heat stroke, the neuroleptic malignant syndrome, or malignant hyperthermia occurs by a common mechanism and, accordingly, that each should respond to dantrolene therapy. While we can be certain that dantrolene is effective in the treatment of malignant hyperthermia and possibly in some cases of the neuroleptic syndrome, I would like to challenge the authors of these articles to cite scientific evidence that dantrolene


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