Journal of Lung Diseases & Treatment

Oral Dantrolene Causing a Decrease in Vital Capacity, Recurrent Lung Collapse, and Respiratory Failure in a Spinal Cord Injury Patient: A Case Report

Abstract

Kevin C. Proud MD, Rana Hejal MD and Hugo Montenegro MD

Introduction: Dantrolene is a muscle relaxant used to treat malignant hyperthermia as well as muscle spasms in spinal cord injury patients. It is known to cause a decrease in skeletal muscle strength in humans, and inhibit diaphragm muscle strength in hamsters. There is at least one other case report of dantrolene leading to respiratory failure in a spinal cord injury patient. Here was present a case of a patient developing poor mucus clearance, lobar collapse and respiratoy failure after being started on dantrolene, and trend vital capacity and negative inspiratory force while titrating off dantrolene.
Case: 47 y/o male with history of motor vehicle accident resulting in tetraplegia 19 months prior to admission, presented with pneumonia for the first time since his accident. He also experienced recurrently episodes of bilateral lung collapse and respiratory failure and was found to have significant respiratory muscle weakness. He had been started on dantrolene approximately six weeks prior to admission. After stopping dantrolene his clinical status and his vital capacity and negative inspiratory force dramatically improved. He was then able to clear his secretions, and had no further episodes of lung collapse.
Discussion: Our case is only the second in literature of dantrolene causing respiratory failure in a spinal cord patient; and is the first to trend daily vital capacity and NIF while the patient is being tapered off the dantrolene. Our case documented a dramatic improvement NIV and VC after stopping dantrolene. Our case demonstrates the potential and avoidable harm of using dantrolene in group of patients for which is commonly prescribed.