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Intensive Care Medicine

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01-09-2003 | Original

Critical illness polyneuromyopathy: the electrophysiological components of a complex entity

Authors: Josef Bednarik, Zdenek Lukas, Petr Vondracek

Published in: Intensive Care Medicine | Issue 9/2003

Abstract

Objective

To evaluate the spectrum and time profile of electrophysiological parameters in the detection of neuromuscular involvement in critically ill patients and establish their correlation with biopsy findings.

Design

Prospective clinical and neurophysiological study.

Setting

One general and one neurological intensive care unit in a university hospital.

Patients

Forty-six critically ill patients with failure of at least two organ systems were enrolled and completed the 1-month follow up.

Interventions

Detailed clinical and electrophysiological evaluation including direct muscle stimulation was performed in all cases on entry and at the end of the follow-up. Muscle biopsy was performed in 11, and sural nerve biopsy in 5, cases.

Measurements and results

Electrophysiological signs of new or progressing neuromuscular involvement at the end of the first month were detected in 26 patients (56%) and could be classified into three groups: "pure motor syndrome" (12 cases), combined motor syndrome and sensory polyneuropathy (13 cases) and isolated sensory polyneuropathy (1 case). Direct muscle stimulation showed decreased muscle membrane excitability in 11 of these abnormal cases. Muscle biopsy disclosed various myopathic abnormalities in all 11 cases examined with motor syndrome, in 7 of them in association with denervation/re-innervation changes.

Conclusions

Electrophysiological and histological examinations showed significant overlapping of several pathogenic components of neuromuscular involvement in critically ill patients, namely decreased muscle excitability, myopathy, axonal motor neuropathy and sensory neuropathy. The characterisation of the electrophysiological components of a complex polyneuromyopathy is preferred to the strict categorisation of abnormalities into critical illness myopathy and polyneuropathy.

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Title: Critical illness polyneuromyopathy: the electrophysiological components of a complex entity
Authors: Josef Bednarik
Zdenek Lukas
Petr Vondracek
Publication date: 01-09-2003
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 9/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1858-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Critical illness polyneuromyopathy: the electrophysiological components of a complex entity

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

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