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Critical Illness Polyneuropathy in a Child: A Case Report

Shiji Chalipat1, Jyothsna Sree Madala2, Sanjay Chavan2

  • 1Pediatric Neurology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to Be University), Pune, IND.

Cureus
|April 22, 2024
PubMed

Insights

Critical illness polyneuropathy and myopathy are often missed in children requiring prolonged mechanical ventilation. Early recognition and supportive care are crucial for recovery in pediatric intensive care unit patients.

Area of Science:

  • Pediatric critical care medicine
  • Neurology
  • Intensive care unit management

Background:

  • Critical illness polyneuropathy (CIP) and myopathy (CIM) are significant complications in critically ill children.
  • These conditions are often underdiagnosed, particularly in those with prolonged intensive care unit (ICU) stays and mechanical ventilation.

Observation:

  • A 10-year-old boy with pneumococcal meningoencephalitis, severe sepsis, and multiorgan dysfunction developed quadriparesis and areflexia.
  • The patient required extended mechanical ventilation, sedation, and inotropic support, with multiple extubation failures.

Findings:

  • Electrophysiology confirmed CIP, specifically acute motor and sensory axonal polyneuropathy.
  • Elevated muscle enzymes were noted, indicating muscle involvement.

Implications:

  • This case highlights the importance of suspecting CIP/CIM in critically ill children.
  • Prompt diagnosis and comprehensive management, including physiotherapy, can lead to improved outcomes, as demonstrated by the patient's recovery.

Keywords:
critical illness polyneuropathyintensive caremeningitismyopathysepticemia

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