This overwhelms the bodys capacity to supply oxygen, remove carbon dioxide, and regulate body temperature, eventually leading to circulatory collapse and death if not treated quickly. Susceptibility to malignant hyperthermia is often inherited as an autosomal dominant disorder, for which there are at least six genetic loci of interest, the most prominent being the ryanodine receptor gene (RYR1). MH susceptibility is phenotype and genetically related to central core disease (CCD), an autosomal dominant disorder characterized both by MH symptoms and by myopathy. MH is usually unmasked by anesthesia, or when a family member develops the symptoms. There is no simple, straightforward test to diagnose the condition. When MH develops during a procedure, treatment with dantrolene sodium is usually initiated; dantrolene and the avoidance of suxamethonium administration in susceptible people have markedly reduced the mortality from this condition. Apnea
The normal short duration of action of suxamethonium is due to the rapid metabolism of the drug by non-specific plasma cholinesterases. However plasma cholinesterase activity is reduced in some people due to either genetic variation or acquired conditions, which results in a prolonged duration of neuromuscular block. Genetically, ninety six percent of the population have a normal (Eu:Eu) genotype and block duration; however, some people have atypical genes (Ea, Es, Ef) which can be found in varying combinations with the Eu gene, or other atypical genes (see Pseudocholinesterase deficiency). Such genes will result in a longer duration of action of the drug, ranging from 20 minutes up to several hours.
Symptoms vary rapidly, perhaps even by the hour, and there is a rapid return to the premorbid state of health." A frequently quoted authority on BD, P. Pichot (Hôpital Sainte Anne, Paris) provides this description of BD: 

sudden onset: a bolt from the blue. manifold delusions without recognizable structure and cohesiveness with/without hallucinations. clouding of consciousness associated with emotional instability. absence of physical signs. rapid return to pre-morbid level of functioning.Pichots criteria can be refined further with these typical clinical characteristics: 

age: usually between 20 and 40 years of age. onset: acute without prior mental illness (with the exception of previous episodes of bouffée délirante). past history: no chronic mental disturbance after resolution of the BD episode. typical symptoms: delusions and/or hallucinations of any type. Depersonalization/derealization and/or confusion
depression and/or elation. symptoms quite variable from day to day and even hour to hour. not due to alcohol, drug use, or organic mental disorder. Formal classification
In 1968 the French national organization INSERM (Institut National de la Santé et de la Recherche Médicale) classification of mental illness referenced two types of BD in their category acute delusional psychoses and confusional states viz. reactive bouffée délirante and bouffée délirante (Magnans type). This classification scheme has been largely replaced by the two nosological systems discussed below.