Critical illness polyneuropathy

Critical illness polyneuropathy
SpecialtyNeurology Edit this on Wikidata

Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are overlapping syndromes of diffuse, symmetric, flaccid muscle weakness occurring in critically ill patients and involving all extremities and the diaphragm with relative sparing of the cranial nerves. CIP and CIM have similar symptoms and presentations and are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy.[1][2] The causes of CIP and CIM are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome.[3] Corticosteroids and neuromuscular blocking agents, which are widely used in intensive care, may contribute to the development of CIP and CIM,[4] as may elevations in blood sugar, which frequently occur in critically ill patients.[5]

CIP was first described by Charles F. Bolton in a series of five patients.[6]

Combined CIP and CIM was first described by Nicola Latronico in a series of 24 patients.[7]

  1. ^ Latronico N, Bolton CF (2011). "Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis". Lancet Neurol. 10 (10): 931–4. doi:10.1016/S1474-4422(11)70178-8. PMID 21939902. S2CID 45670414.
  2. ^ Maramattom BV, Wijdicks EF (2006). "Acute neuromuscular weakness in the intensive care unit". Crit. Care Med. 34 (11): 2835–41. doi:10.1097/01.CCM.0000239436.63452.81. PMID 16932235. S2CID 10556731.
  3. ^ Cite error: The named reference EJN was invoked but never defined (see the help page).
  4. ^ Schweickert WD, Hall J (2007). "ICU-acquired weakness". Chest. 131 (5): 1541–9. doi:10.1378/chest.06-2065. PMID 17494803.
  5. ^ Hermans G; Wilmer A; Meersseman W; et al. (2007). "Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit". Am. J. Respir. Crit. Care Med. 175 (5): 480–9. doi:10.1164/rccm.200605-665OC. PMID 17138955.
  6. ^ Bolton CF; Gilbert JJ; Hahn AF; Sibbald, W.J. (November 1984). "Polyneuropathy in critically ill patients". J Neurol Neurosurg Psychiatry. 47 (11): 1223–31. doi:10.1136/jnnp.47.11.1223. PMC 1028091. PMID 6094735.
  7. ^ Latronico N; Fenzi F; Recupero D; et al. (1996). "Critical illness myopathy and neuropathy". Lancet. 347 (9015): 1579–82. doi:10.1016/S0140-6736(96)91074-0. PMID 8667865.