The differential diagnosis of generalized weakness depends on the situation in which the patient is encountered. In general, patients seen after cardiothoracic procedures (especially extensive aortic repairs) tend to have ischemic myelopathies; patients in medical ICUs with critical illness, sepsis, or SIRS and on mechanical ventilation tend to have CIM, CIP, or prolonged NM blockade. Consideration of the common causes of neuromuscular weakness and adequate electrophysiological work-up will help to identify a large proportion of these patients with neurologic weakness. Nerve-muscle biopsies play an important role in subclassification of the underlying syndrome and in prognostication. Although the predominant determinant of outcome is the underlying illness, supportive care is of paramount importance and a multidisciplinary approach to patient care is necessary to ensure a speedy and satisfactory functional recovery.
Eelco F. M. Wijdicks, MD, Mayo Clinic College of Medicine, Division of Critical Care Neurology, Department of Neurology, W8B, 200 First Street SW, Rochester, MN 55905. E-mail: firstname.lastname@example.org .
Crit Care Med. 2006;34(11):2835-2841. © 2006 Lippincott Williams & Wilkins
Cite this: Acute Neuromuscular Weakness In The Intensive Care Unit - Medscape - Nov 01, 2006.