Mozaffar T, Mozaffar F H.
Critical Care Myopathy: an emerging medical catastrophe
J Pak Med Assoc Dec 2003;53(12):608-11.
University of California-Irvine, Irvine, California, USA

This syndrome is characterized by sub-acute onset of flaccid weakness and respiratory failure. Typical course is development of muscle weakness over days to weeks. The muscle weakness may be variable and ranges from mild weakness to severe quadriplegia. The muscle weakness follows a typical pattern of proximal greater than distal weakness, but diffuse muscle weakness may be seen. Facial muscle weakness is common but the extraocular muscles are often spared. Sensory dysfunction is uncommon but is difficult to ascertain due to difficulty with communication with paralyzed intubated patients. A length-dependent polyneuropathy often co-exists in majority of the patients. Deep tendon reflexes are often depressed, even in patients with no electrodiagnostic evidence of neuropathy. This leads to clinical confusion between myopathy versus neuropathy. Respiratory insufficiency is invariable in severe cases, and failure to wean from mechanical ventilation is often the initial manifestation. Since most of these cases are associated with prolonged neuromuscular blockade, the presence of prolonged paralysis from persistent neuromuscular blockade needs to be ruled out. This is a review article.

Category: Neurology
Keywords: Myopathy. Critical Care Myopathy. Proximal Myopathy. Neuropathy.

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