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[Critical illness polyneuropathy: case report].

L B Alvim1, M R De Freitas, O J Do Nascimento

  • 1Serviço de Neurologia, Faculdade de Medicina, Universidade Federal Fluminese (UFF), Brasil.

Arquivos De Neuro-Psiquiatria
|July 21, 1999
PubMed
Summary
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Critical illness neuropathy, an axonal motor neuropathy, affects patients in intensive care units. This case report details a patient

Area of Science:

  • Neurology
  • Critical Care Medicine
  • Pathology

Background:

  • Critical illness polyneuropathy (CIP) is a common complication in critically ill patients, particularly those with sepsis or multiple organ failure.
  • CIP typically presents as an acute-onset, predominantly motor axonal neuropathy, often requiring mechanical ventilation.
  • Diagnosis is typically supported by electrophysiologic studies, such as electroneuromyography.

Observation:

  • A 35-year-old female developed tetraparesis following sepsis and intrauterine fetal demise management in an intensive care unit.
  • Clinical examination revealed significant motor and sensory deficits.
  • Electromyography demonstrated reduced amplitude of motor and sensory potentials, positive sharp waves, and fibrillations.

Findings:

Related Experiment Videos

  • Sural nerve biopsy confirmed an axonmyelinic neuropathy, consistent with critical illness neuropathy.
  • The patient experienced substantial functional improvement within four months of onset.
  • These electrophysiological and histopathological findings align with established literature on critical illness neuropathy.

    • Implications:

    • This case reinforces the diagnosis of critical illness neuropathy in patients with severe sepsis and prolonged critical care.
    • The findings highlight the potential for significant recovery from critical illness neuropathy, even in severe presentations.
    • Early recognition and diagnosis of critical illness neuropathy are crucial for appropriate management and prognostication in intensive care settings.