Heat strokes: Aetiopathogenesis, neurological characteristics, treatment and outcome

Journal of the Neurological Sciences

Volumn 156, Issue 2, 1998, Pages 144-151

  Yaqub, Basim ^a   Al Deeb, Saleh ^a  

^a The General Directorate of Armed Forces Health Services   (Saudi Arabia)

Author keywords

Creatinine kinase; Dantrolene; Heat stroke; Malignant hyperthermia; Neuroleptic malignant syndrome; Pancerebellar syndrome

Indexed keywords

CLINICAL EXAMINATION; COOLING; HEAT STROKE; HUMAN; NEUROLOGIC DISEASE; OUTCOMES RESEARCH; PATHOGENESIS; PRIORITY JOURNAL; REVIEW; THERMOGENESIS; THERMOREGULATION;

ANIMALS; ATROPHY; CEREBELLUM; HEAT STROKE; HUMANS; TREATMENT OUTCOME;

EID: 0032054884     PISSN: 0022510X     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0022-510X(98)00037-9     Document Type: Review

References (115)

1. Akhtar M.J., Al-Nozha M., Al-Harthi S., Nouh M.S. Electrocardiographic abnormalities in patients with heat stroke. Chest. 104:1993;411-414.
2. Al-Aska A.K., Abu-Aisha H., Yaqub B., Al-Harthi S.S., Sallam A. Simplified cooled bed for heatstroke. Lancet. 1:1986;381.
3. Al-Aska A.K., Yaqub B.A., Al-Harthi S.S., Al-Dalaan A. Rapid cooling in management of heat stroke: clinical methods and practical implications. Ann. Saudi Med. 7:1987;135-138.
4. Al-Harthi S.S., Yaqub B.A., Al-Nozha M., Al-Aska A.K., Seraj M. Management of heat stroke patients by rapid cooling at Mecca Pilgrimage (Haj 1404) comparing a conventional method with a body cooling unit. Saudi Med. J. 7:1986;369-376.
5. Al-Harthi S.S., Nouh M.S., Al-Arfaj H., Qaraquish A., Akhter J., Nouh R.M. Non-invasive evaluation of cardiac abnormalities in heat stroke pilgrims. Int. J. Cardiol. 37:1992;151-154.
6. Al-Mashhadani S.A., Gader A.G., Al-Harthi S.S., Kangav D., Shaheed F.A., Bogus F. The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah. Blood Coagul. Fibrinolysis. 5:1994;731-736.
7. Amore M., Cerisoli M. Heatstroke and hyperthermias. Ital. J. Neurol. Sci. 13:1992;337-341.
8. Amundson D.E., Summa R.A. Exertional heatstroke. Mil. Med. 157:1992;A6.
9. Anonymous, 1993. Heat-related deaths - United States, 1993. Morbidity and Mortality Weekly Report 42, 558-560.
10. Anonymous, 1994. Heat-related deaths - Philadelphia and United States, 1993-1994. Morbidity and Mortality Weekly Report 43, 453-455.
11. Antunano M.J., Nunneley S.A. Heat stroke in protective clothing: validation of a computer model and the heat-humidity index (HHI). Aviat. Space Environ. Med. 63:1992;1087-1092.
12. Armstrong L.E., Maresh C.M. The introduction and decay of heat acclimatisation in trained athletes. Sports Med. 12:1991;302-312.
13. Ash C.J., Cook J.R., McMurry T.A., Auner C.R. The use of rectal temperature to monitor heat stroke. Mo. Med. 89:1992;283-288.
14. Attia M., Khogali M., El-Khatib G., Mustafa M.K., Mahmoud N.A., Eldin A.N., Gumaa K. Heat stroke: an upward shift of temperature regulation set point at an elevated body temperature. Int. Arch. Occup. Environ. Health. 53:1983;9-17.
15. Bacon C., Scott D., Jones P. Heat stroke in well wrapped infants. Lancet. 1:1979;422-425.
16. Beard M.E., Hamer J.W., Hamilton G., Maslowski A.H. Jogger's heat stroke. New Zealand Med. J. 89:1979;159-161.
17. Bergstrom G., Aneman A., Pettersson B. Varmeslag efter motionslopp med allvarliga effekter pa lever-och blodningsstatus. Lakartidningen. 89:1992;2686-2687.
18. Biary N., Madkour M.M., Sharif H. Post heat stroke parkinsonism and cerebellar dysfunction. Clin. Neurol. Neurosurg. 97:1995;55-57.
19. Bligh J. Iavliaetsia li tsentral'nyi kontrol' postoianstva temperatury primeron gomeostazisa? (Obsuzhdenie teorri i dokazatel'stv). Fiziol. Zh. SSSR Im. I. M. Sechenova. 67:1981;1068-1078.
20. Bouchama A., Cafege A., Devol E.B., Labdi O., El-Assil K., Seraj M. Ineffectiveness of dantrolene sodium in the treatment of heat stroke. Crit. Care Med. 19:1991;176-180.
21. Bouchama A., Cafege A., Robertson W., Al-Dossary S., El-Yazigi A. Mechanisms of hypophosphatemia in humans with heat stroke. J. Appl. Physiol. 71:1991;328-332.
22. Bouchama A., Al Hussein K., Adra C., Rezeig M., Al Shail E., Al Sedairy S. Distribution of peripheral blood leukocytes in acute heatstroke. J. Appl. Physiol. 73:1992;405-409.
23. Bouchama A., Al-Sedairy S., Siddiqui S., Shail E., Rezeig M. Elevated pyrogenic cytokines in heatstroke. Chest. 104:1993;1498-1502.
24. Bross M.H., Nash B.T. Jr., Carlton F.B. Jr. Heat emergencies. Am. Fam. Phys. 50:1994;389-396.
25. Brown J., Mitchell S. A complicated case of exertional heat stroke in a military setting with persistent elevation of creatine phosphokinase. Mil. Med. 157:1992;101-103.
26. Cabanac M. Selective brain cooling in humans: 'fancy' or fact? FASEB J. 7:1993;1143-1147.
27. Chang D.M. The role of cytokines in heat stroke. Immunol. Invest. 22:1993;553-561.
28. Charatan F.B. Hundreds die in US as temperatures reach 41 degrees C. Br. Med. J. 311:1995;277.
29. Conemans J.M. Psychiatrische medicatie als risicofactor voor fatale hittecollaps. Ned. Tijdschr. Geneeskd. 139:1995;1759-1760.
30. Clowes C.H. Jr., O'Donnell T.F. Jr. Heat stroke. New Engl. J. Med. 291:1987;564-567.
31. Dahmash N.S., Al-Harthi S.S., Akhtar J. Invasive evaluation of patients with heat stroke. Chest. 103:1993;1210-1214.
32. Dann E.J., Berkman N. Chronic idiopathic anhydrosis - a rare cause of heat stroke. Postgrad. Med. J. 68:1992;750-752.
33. Delgado G., Tunon T., Gallego J., Villanueva J. Spinal cord lesions in heat stroke. J. Neurol. Neurosurg. Psychiatry. 48:1985;1065-1067.
34. Denborough M.A. Heat strike and malignant hyperpyrexia. Med. J. Aust. 1:1982;204-205.
35. El Awad M.E. Overheating in neonates in Saudi Arabia. East Afr. Med. J. 71:1994;805-806.
36. Ellis F.R. Mortality from heat illness and heat aggravated illness in United States. Environ. Res. 5:1972;1-58.
37. El-Sonbaty M.R., Abdul-Ghaffar N.U. Hypokalaemic paralysis precipitated by working in hot weather. Trop. Doct. 25:1995;64-66.
38. Epstein Y., Sohar E., Shapiro Y. Exertional heatstroke: a preventable condition. Isr. J. Med. Sci. 31:1995;454-462.
39. Faunt J.D., Wilkinson T.J., Aplin P., Henschke P., Webb M., Penhall R.K. The effete in the heat: heat-related hospital presentations during a ten day heat wave. Aust. New Zealand J. Med. 25:1995;117-121.
40. Feller R.B., Wilson J.S. Hepatic failure in fatal exertional heatstroke. Aust. New Zealand J. Med. 24:1994;69.
41. Ferris E.B. Jr., Blankenhorn M.A., Robinson H.W. Heat stroke: clinical and chemical observations on 44 cases. J. Clin. Invest. 17:1938;249-262.
42. Fijnheer R., van de Ven P.J., Erkelens D.W. Psychiatrische medicatie als risicofactor voor fatale hittecollaps. Ned. Tijdschr. Geneeskd. 139:1995;1391-1393.
43. Garcia-Rubira J.C., Aguilar J., Romero D. Acute myocardial infarction in a young man after heat exhaustion. Int. J. Cardiol. 47:1995;297-300.
44. Gardner J.W., Kark J.A. Fatal rhabdomyolysis presenting as mild heat illness in military training. Mil. Med. 159:1994;160-163.
45. Gauss H., Meyer K.A. Heat stroke: report of 158 cases from Cook County Hospital. Chicago Am. J. Med. Sci. 154:1917;554-564.
46. Grove I., Isaacson N. The pathology of hyperpyrexia: observation at autopsy in 17 cases of fever therapy. Am. J. Pathol. 25:1949;1029-1046.
47. Hart G.R., Anderson R.J., Crumpler C.P., Shulkin A., Reed G., Knochel J.P. Epidemic classical heat stroke: clinical characteristic and course of 28 patients. Medicine (Baltimore). 61:1982;189-197.
48. Hart L.E., Egier B.P., Shimizu A.G., Taudan P.M., Sutton J.R. Exertional heat stroke: the runner's nemesis. Can. Med. Assoc. J. 122:1980;1144-1150.
49. Hassanein T., Perper J.A., Tepperman L., Starzl T.E., van Thiel D.H. Liver failure occurring as a component of exertional heat stroke. Gastroenterology. 100:1991;1442-1447.
50. Hassanein T., Razack A., Gavaler J.S., van Thiel D.H. Heatstroke: its clinical and pathological presentation, with particular attention to the liver. Am. J. Gastroenterol. 87:1992;1382-1389.
51. Helzer-Julin N. Sun, heat, and cold injuries in cyclists. Clin. Sports Med. 13:1994;219-234.
52. Heytens L., Martin J.J., van de Kelft E., Bossaert L.L. In vitro contracture tests in patients with various neuromuscular diseases. Br. J. Anaesth. 68:1992;72-75.
53. Jones T.S., Liang A.P., Kilbourne E.M., Griffin M.R., Patriarca P.A., Wassilak S.G., Mullan R.J., Herrick R.F., Donnell H.D. Jr., Choi K., Thacker S.B. Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City MO. J. Am. Med. Assoc. 247:1982;3327-3331.
54. Kao T.Y., Chio C.C., Lin M.T. Hypothalamic dopamine release and local cerebral blood flow during onset of heatstroke in rats. Stroke. 25:1994;2483-2487.
55. Khogali M., Weiner J.S. Heat stroke: report of 18 cases. Lancet. 2:1980;276-278.
56. Khogali, M., El-Sayed, H., Amar, M., 1983. Management and therapy regimen during cooling and in the recovery room at different heat stroke treatment centres. In: Khogali, M., Hales J.R. (Eds.), Heat Stroke and Temperature Regulation, Academic Press, Sydney, pp. 149-156.
57. Kilbourne E.M., Choi K., Jones K.S., Thacker S.B. Risk factors for heat stroke. A case-control study. J. Am. Med. Assoc. 247:1982;3332-3336.
58. King K., Negus K., Vance J.C. Heat stroke in vehicles: a problem in infancy. Paediatrics. 68:1981;579-582.
59. Lazar A.I. Acute renal failure in severe exertional rhabdomyolysis. J. Assoc. Physicians India. 41:1993;57-59.
60. Lee-Chiong T.L. Jr., Stitt J.T. Heat stroke and other heat-related illnesses. Postgrad. Med. 98:1995;31-33.
61. Lefkowitz D., Ford C., Rich C., Biller J., McHenry L. Jr. Cerebellar syndrome following neuroleptic induced heat stroke. J. Neurol. Neurosurg. Psychiatry. 46:1983;183-185.
62. Lelis M., Do Carmo G., Caldeira L., Abreu J., Freitas L., Doroana M. Febrile coma and disseminated intravascular coagulation following heat stroke. Acta Med. Port. 5:1992;215-218.
63. Lim M.K. Occupational heat stress. Ann. Acad. Med. 23:1994;719-724.
64. Lin J.J., Chang M.K., Sheu Y.D., Ting K.S., Sung S.C., Lin T.Q. Permanent neurologic deficits in heat stroke. Chin. Med. J. 47:1991;133-138.
65. Lin M.T., Kao T.Y., Su C.F., Hsu S.S. Interleukin-1 beta production during the onset of heat stroke in rabbits. Neurosci. Lett. 174:1994;17-20.
66. Loffeld R.J., Appel A. Inspanningsgebonden stoornissen in de warmteregulatie bij 8 deelnemers aan de Dam-tot-Dam-loop 1993. Ned. Tijdschr. Geneeskd. 138:1994;910-913.
67. Lumlertgul D., Chuaychoo B., Thitiarchakul S., Srimahachota S., Sangchun K., Keoplung M. Heat stroke-induced multiple organ failure. Renal Fail. 14:1992;77-80.
68. Malamud N., Haymaker W., Custer R.P. Heat stroke: a clinico-pathological study of 125 fatal cases. Mil. Surg. 99:1946;394-449.
69. Marino A., Pellegrini F., Lucchesi A.M., Roncucci P., Cosimi A., Logi G. Danno multiorgano nel colpo di calore da sforzo. Min. Anestesiol. 58:1992;393-395.
70. Mehta A., Baker R. Resistant neurological deficit in heat stroke. Neurology. 20:1970;336-340.
71. Miralles R., Garces J.M., Molina L., Acena R., Garcia Palleiro P. Sindromes por agotamiento en una maraton popular. Med. Clin. 100:1993;343-345.
72. Nielsen B. Heat stress and acclimatisation. Ergonomics. 37:1994;49-58.
73. Noback, C.R. (Ed.), 1981. The Human Nervous System: Basic Principles and Neurobiology, 3rd ed. McGraw-Hill, New York, pp. 378-379.
74. O'Donnell T.J. Jr. The haemodynamic and metabolic alterations associated with acute stress injury in marathon runners. Ann. New York Acad. Sci. 301:1977;262-269.
75. Ohshima T., Maeda H., Takayasu T., Fujioka Y., Nakaya T. An autopsy case of infant death due to heat stroke. Am. J. Forensic Med. Pathol. 13:1992;217-221.
76. Orimo S., Taniguchi A., Ichikawa T., Hiyamuta E., Tamaki M. Two familial cases with exertion-induced heat stroke-relationship to malignant hyperthermia. Clin. Neurol. 32:1992;412-415.
77. Orser B. Dantrolene sodium and heat stroke. Crit. Care Med. 20:1992;1192-1193.
78. Panjwani G.D., Mustafa M.K., Muhailan A., Aneja I.S., Owunwanne A. Effect of hyperthermia on somatosensory evoked potentials in the anaesthetized rat. Electroencephalogr. Clin. Neurophysiol. 80:1991;384-391.
79. Park N.M. Heat stroke in psychiatric patients: two cases and a review. J. Clin. Psychiatry. 1:1982;377-380.
80. Pascoe D.D., Shanley L.A., Smith E.W. Clothing and exercise. I: Biophysics of heat transfer between the individual, clothing and environment. Sports Med. 8:1994;38-54.
81. Payen J.F., Bourdon L., Reutenauer H., Melin B., Le Bas J.F., Stieglitz P., Cure M. Exertional heatstroke and muscle metabolism: an in vivo 31P-MRS study. Med. Sci. Sports Exerc. 24:1992;420-425.
82. Piekarski C. Climatic stress in coalmining in Germany: occupational health aspects. Ergonomics. 38:1995;23-35.
83. Porter A.M. Heat illness and soldiers. Mil. Med. 158:1993;606-609.
84. Richards R., Richards D., Sutton J. Exertion-induced heat exhaustion. An often overlooked diagnosis. Aust. Fam. Physician. 21:1992;18-24.
85. Robinson S., Robinson A.H. Chemical composition of sweat. Physiol. Rev. 34:1954;202-220.
86. Royburt M., Epstein Y., Solomon Z., Shemer J. Long-term physiological effects of heat stroke. Physiol. Behav. 54:1993;265-267.
87. Sarnquist F., Larsson C.F. Jr. Drug induced heat stroke. Anesthesiology. 39:1973;348-350.
88. Savdie E., Prevedoros H., Irish A., Vickers C., Concannon A., Darveniza P., Sutton J.R. Heat stroke following Rugby League football. Med. J. Aust. 155:1991;636-639.
89. Seraj M.E. Heat stroke during Hajj (Pilgrimage) - an update. Middle East J. Anesthesiol. 11:1992;407-441.
90. Shibolet S., Lancaster M., Danon Y. Heat stroke: a review. Aviat. Space Environ. Med. 47:1976;280-301.
91. Shibolet S.B., Coll R., Gilat T., Sohar E. Heat stroke: its clinical picture and mechanism in 36 cases. Q.J. Med. 36:1967;525-548.
92. Simon H.B. Hyperthermia and heatstroke. Hosp. Pract. 29:1994;65-68.
93. Squires L.A., Neumeyer A.M., Bloomberg J., Krishnamoorthy K.S. Hyperpyrexia in an adolescent on desipramine treatment. Clin. Pediatr. 31:1992;635-636.
94. Starr A. Auditory brainstem responses in brain death. Brain. 99:1976;543-544.
95. Stolwijk J.A.J., Nadel E.R. Thermoregulation during positive and negative work exercise. Fed. Proc. 32:1973;1607-1613.
96. Torre-Cisneros J., Fernandez de la Puebla Gimenez R.A., Jimenez Pereperez J.A., Lopez Miranda J., Villanueva Marcos J.L., Blanco Molina A., Perez-Jimenez F. The early prognostic assessment of heat stroke. Rev. Clin. Esp. 190:1992;439-442.
97. Van Der Linde A., Kielblock A.J., Rex D.A., Terblanche S.E. Diagnostic and prognostic criteria for heat stroke with special reference to plasma enzyme and isoenzyme release patterns. Int. J. Biochem. 24:1992;477-485.
98. Vaughn L.K., Veale W.L., Cooper K.E. Antipyresis: its effect on mortality rate of bacterially infected rabbits. Brain Res. Bull. 5:1980;69-73.
99. Vera Z.A., Cross C.E. Cardiovascular alterations in heat stroke. Chest. 103:1993;987-988.
100. Wang A.Y., Li P.K., Lui S.F., Lai K.N. Renal failure and heat stroke. Renal Fail. 17:1995;171-179.
101. Watson J.D., Ferguson C., Hinds C.J., Skinner R., Coakley J.H. Exertional heat stroke induced by amphetamine analogues. Does dantrolene have a place? Anaesthesia. 48:1993;1057-1060.
102. Weiner J.S., Khogali M. A physiological body-cooling unit for treatment of heat stroke. Lancet. 1:1980;507-509.
103. White J.D., Kamath R., Nucci R., Johnson C., Shepherd S. Evaporation versus iced peritoneal lavage treatment of heatstroke: comparative efficacy in a canine model. Am. J. Emerg. Med. 11:1993;1-3.
104. Whitworth J.A.G., Wolfman M.J. Fatal heat stroke in long distance runners. Br. Med. J. 287:1983;948.
105. Wilbur E., Stevena J. Morbid anatomic changes following artificial fever, with report of autopsies. South. Med. J. 30:1937;286-289.
106. Wilcox W.H. The nature, prevention and treatment of heat pyrexia. Br. Med. J. 1:1920;392-397.
107. Wyndham C.H. A survey of the causal factors in heat stroke and their prevention in gold mining industry. J. S. Afr. Inst. Mining Metallurg. 1:1966;245-258.
108. Wyndham C.H. The physiology of exercise under heat stroke. Ann. Rev. Physiol. 35:1973;193-220.
109. Wyndham C.H., Syndrom N.B., Cooke H.M. Methods of cooling subjects with hyperpyrexia. J. Appl. Physiol. 14:1959;771-776.
110. Yaqub B.A. Neurologic manifestations of heatstrokes at the Mecca pilgrimage. Neurology. 37:1987;1004-1006.
111. Yaqub B.A. Brainstem auditory evoked potentials in heat stroke: diagnostic and prognostic value. Saudi Med. J. 9:1988;49-53.
112. Yaqub B.A., Al-Harthi S.S., Al Orainey I.O., Laajan M.A., Obeid M.T. Heat stroke at the Mekkah Pilgrimage: clinical characteristics and course of 30 patients. Q. J. Med. 59:1986;523-530.
113. Yaqub B.A., Daif A.K., Panayiotopoulos C.P. Pancerebellar syndrome in heat stroke: clinical course and CT scan findings. Neuroradiology. 29:1987;294-296.
114. Yaqub B.A., Obeid T., Seraj M.A. Neuroleptic malignant syndrome and heat stroke: spectrum of a clinical syndrome. Saudi Med. J. 10:1989;254-259.
115. Zelman S., Guillian R. Heat stroke in phenothiazine treated patients: a report of three families. Am. J. Psychiatry. 126:1970;1787-1790.