Neurological and Neuromuscular Complications of Systemic Critical Illness
Neurological complications of acute systemic illnesses involve both central and peripheral parts of the nervous system and contribute to mortality and morbidity. Acute encephalopathy is the most common neurological complication in ICU patients. In addition, a variety of neuromuscular disorders have been described in critically ill patients, including a sensorimotor axonal polyneuropathy (critical illness polyneuropathy), disuse atrophy, steroid-induced myopathy, persistent neuromuscular blockage following the use of neuromuscular blocking agents, and an acute necrotizing myopathy in patients concomitantly receiving a neuromuscular blocking agent and corticosteroids. Some authors have used the term ICU/critical illness myopathy to describe the myopathy found in ICU patients. However, as there may be different forms of this condition, I prefer to classify these disorders according to the associated features and inciting factors. It is often extremely difficult to distinguish these disorders from each other on purely clinical grounds, although certain clues may make one more likely. Nerve conduction studies, needle electromyography, and muscle biopsy are often necessary to make a firm diagnosis.
KeywordsCritical Illness Neuromuscular Blocking Agent Critical Illness Polyneuropathy Sensory Nerve Action Poten Critical Illness Myopathy
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