Critical Illness Polyneuropathy; A Review of Seven Cases

J Korean Neurol Assoc > Volume 17(6); 1999 > Article

Journal of the Korean Neurological Association 1999;17(6): 853-860.

Critical Illness Polyneuropathy;A Review of Seven Cases

강지훈, 김광국

울산대학교 의과대학 서울중앙병원 신경과

Critical Illness Polyneuropathy; A Review of Seven Cases

Ji-Hoon Kang, M.D., Kwang-Kuk Kim, M.D.

Department of Neurology, College of Medicine, University of Ulsan, Asan Medical Center

Abstract

Background : Critical illness polyneuropathy(CIP) is a recognized cause of muscle weakness and failure of weaning from a ventilator during the course of sepsis and multi-organ failure. We experienced seven patients of polyneuropathy associated with critical illness, and reviewed the cases in order to characterize the clinical features of CIP. Methods : We evaluated seven patients who developed polyneuropathy for the first time during intensive care at the Asan Medical Center from Feb, 1998 to Mar, 1999. Results : CIP occurred usually 2-8 weeks after admission to the intensive care unit. All patients received ventilator care due to severe pulmonary problems, which included pneumonia, ARDS, and empyema. Five of them had sepsis. All patients had quadriparesis prominently in the distal area, muscle atrophy, decreased tendon reflexes, and distal hypoesthesia. Electrophysiological and pathologic studies were compatible with axonal polyneuropathy. Five patients recovered from the underlying critical illness and regained their muscle power with improved findings on follow-up nerve conduction studies. Conclusions : Critical illness should be considered as a cause of polyneuropathy in severely ill patients, especially if associated with sepsis. After recovery from illness, motor weakness as well as electrophysiological findings improved. Failure of weaning from a ventilator may be more affected by pre-existing cardiopulmonary problems than CIP. J Korean Neurol Assoc 17(6):853~860, 1999 Key Words : Critical illness polyneuropathy, Sepsis, Intensive care, Axonopathy, Ventilator weaning