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Polyneuropathy in critically ill patients.

C F Bolton, J J Gilbert, A F Hahn

    Journal of Neurology, Neurosurgery, and Psychiatry
    |November 1, 1984
    PubMed
    Summary
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    Critical illness, including sepsis, can cause severe polyneuropathy. Early signs include ventilator weaning difficulty and limb weakness. Nutritional support may aid recovery in these patients.

    Area of Science:

    • Neurology
    • Critical Care Medicine
    • Electrophysiology

    Background:

    • Critical illness, sepsis, and multiorgan dysfunction can lead to severe neurological complications.
    • Polyneuropathy is a potential complication in critically ill patients, impacting motor and sensory functions.
    • Early clinical signs may include ventilator weaning difficulties and limb flaccidity.

    Purpose of the Study:

    • To describe the clinical, electrophysiological, and morphological features of polyneuropathy in critically ill patients.
    • To investigate the potential role of nutritional factors in the development and recovery of critical illness polyneuropathy.
    • To highlight diagnostic criteria and management implications for this condition.

    Main Methods:

    • Case series of five patients with severe polyneuropathy during critical illness.

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  • Clinical assessment including respiratory function and limb examination.
  • Electrophysiological studies (needle electrode examination) and morphological analysis of skeletal muscle.

    • Main Results:

    • All five patients developed severe motor and sensory polyneuropathy.
    • Electrophysiological studies confirmed a primary axonal polyneuropathy with central nervous system sparing.
    • Polyneuropathy showed improvement in all patients following initiation of total parenteral nutrition.

    Conclusions:

    • Critical illness polyneuropathy is a distinct entity diagnosed via electrophysiology.
    • Nutritional support, specifically total parenteral nutrition, may contribute to recovery.
    • Early diagnosis and intensive management are crucial for potential recovery from critical illness polyneuropathy.