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Electrophysiology of neuromuscular disorders in critical illness

Identifieur interne : 001223 ( Main/Exploration ); précédent : 001222; suivant : 001224

Electrophysiology of neuromuscular disorders in critical illness

Auteurs : David Lacomis [États-Unis]

Source :

RBID : ISTEX:3DF741923402C7B2D147E7D4F8E47A7AB99B312D

English descriptors

Abstract

Introduction: Neuromuscular disorders, predominantly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) occur in approximately one‐third of patients in intensive care units. The aim of this study was to review the important role of electrophysiology in this setting. Results: In CIM, sarcolemmal inexcitability causes low amplitude compound muscle action potentials (CMAPs) that may have prolonged durations. Needle electrode examination usually reveals early recruitment of short duration motor unit potentials, often with fibrillation potentials. In CIP, the findings are usually those of a generalized axonal sensorimotor polyneuropathy. Direct muscle stimulation aids in differentiating CIP and CIM and in identifying mixed disorders along with other electrodiagnostic and histopathologic studies. Identifying evolving reductions in fibular CMAP amplitudes in intensive care unit (ICU) patients predicts development of neuromuscular weakness. Conclusions: Knowledge of the various neuromuscular disorders in critically ill patients, their risk factors, and associated electrodiagnostic findings can lead to development of a rational approach to diagnosis of the cause of neuromuscular weakness in ICU patients. Muscle Nerve 47: 452–463, 2013

Url:
DOI: 10.1002/mus.23615


Affiliations:


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<term>Abnormality</term>
<term>Accid weakness</term>
<term>Acute myopathy</term>
<term>Acute quadriplegic myopathy</term>
<term>Amplitude</term>
<term>Animal model</term>
<term>Arch neurol</term>
<term>Asthmaticus</term>
<term>Axonal</term>
<term>Axonal degeneration</term>
<term>Axonal sensorimotor polyneuropathy</term>
<term>Bers</term>
<term>Better outcomes</term>
<term>Bolton</term>
<term>Brillation</term>
<term>Brillation potentials</term>
<term>Bular motor</term>
<term>Cause ventilatory failure</term>
<term>Clin</term>
<term>Clin neuromuscul</term>
<term>Clin neurophysiol</term>
<term>Clinical features</term>
<term>Cmap</term>
<term>Cmap amplitude</term>
<term>Cmap amplitudes</term>
<term>Cmap duration</term>
<term>Cmap durations</term>
<term>Cmaps</term>
<term>Compound muscle action</term>
<term>Concentric needle electrode</term>
<term>Conduction</term>
<term>Conduction block</term>
<term>Conduction velocities</term>
<term>Corticosteroid</term>
<term>Crimyne study</term>
<term>Crit</term>
<term>Crit care</term>
<term>Critical illness</term>
<term>Critical illness figure</term>
<term>Critical illness myopathy</term>
<term>Critical illness polyneuromyopathy</term>
<term>Critical illness polyneuropathy</term>
<term>Cycle artifact</term>
<term>Direct muscle</term>
<term>Direct muscle stimulation</term>
<term>Direct needle stimulation</term>
<term>Disorder</term>
<term>Distal muscles</term>
<term>Dmcmap</term>
<term>Dmcmap ratio</term>
<term>Early recruitment</term>
<term>Electrical safety</term>
<term>Electrodiagnostic</term>
<term>Electrodiagnostic testing</term>
<term>Electrophysiological studies</term>
<term>Engl</term>
<term>Fibrillation</term>
<term>Fibrillation potentials</term>
<term>Full recovery</term>
<term>Illness</term>
<term>Illness myopathy</term>
<term>Intensive care</term>
<term>Intensive care patients</term>
<term>Intensive care unit</term>
<term>Intensive care units</term>
<term>Intensive insulin therapy</term>
<term>Intensive treatment</term>
<term>Intravenous corticosteroids</term>
<term>Ivcs</term>
<term>John wiley</term>
<term>Lacomis</term>
<term>Lament loss</term>
<term>Liver transplantation</term>
<term>Major risk factor</term>
<term>Major risk factors</term>
<term>Mechanical ventilation</term>
<term>Motor neuron diseases</term>
<term>Multiple organ failure</term>
<term>Mups</term>
<term>Muscle biopsy</term>
<term>Muscle fiber conduction velocity</term>
<term>Muscle membrane excitability</term>
<term>Muscle nerve</term>
<term>Muscle nerve copyright</term>
<term>Muscle nerve march</term>
<term>Myasthenia gravis</term>
<term>Myopathy</term>
<term>Myosin</term>
<term>Myosin atpase</term>
<term>Myosin loss</term>
<term>Ndings</term>
<term>Necmap</term>
<term>Needle electrode examination</term>
<term>Needle electromyography</term>
<term>Needle examination</term>
<term>Nerve</term>
<term>Nerve conduction studies</term>
<term>Nerve conductions</term>
<term>Neurol</term>
<term>Neurol neurosurg psychiatry</term>
<term>Neurology</term>
<term>Neuromuscular</term>
<term>Neuromuscular blockade</term>
<term>Neuromuscular disease</term>
<term>Neuromuscular disorders</term>
<term>Neuromuscular junction blockade</term>
<term>Neuromuscular junction disorders</term>
<term>Neuromuscular weakness</term>
<term>Neuropathy</term>
<term>Nutritional factors</term>
<term>Organ failure</term>
<term>Other causes</term>
<term>Other hand</term>
<term>Paralytic</term>
<term>Paralytic agents</term>
<term>Periodic paralysis</term>
<term>Polyneuropathy</term>
<term>Positive waves</term>
<term>Prospective studies</term>
<term>Prospective study</term>
<term>Protein kinase</term>
<term>Proximal muscles</term>
<term>Pulmonary disease</term>
<term>Quadriplegic</term>
<term>Repetitive stimulation</term>
<term>Respiratory failure</term>
<term>Respircrit care</term>
<term>Risk factors</term>
<term>Sarcoplasmic reticulum</term>
<term>Sepsis</term>
<term>Septic patients</term>
<term>Septic shock</term>
<term>Severe asthma</term>
<term>Severe weakness</term>
<term>Status asthmaticus</term>
<term>Substantial weakness</term>
<term>Syndrome</term>
<term>Systemic response syndrome</term>
<term>Thick filaments</term>
<term>Vast majority</term>
<term>Velocity recovery cycles</term>
<term>Ventilator dependency</term>
<term>Ventilatory</term>
<term>Ventilatory failure</term>
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<div type="abstract">Introduction: Neuromuscular disorders, predominantly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) occur in approximately one‐third of patients in intensive care units. The aim of this study was to review the important role of electrophysiology in this setting. Results: In CIM, sarcolemmal inexcitability causes low amplitude compound muscle action potentials (CMAPs) that may have prolonged durations. Needle electrode examination usually reveals early recruitment of short duration motor unit potentials, often with fibrillation potentials. In CIP, the findings are usually those of a generalized axonal sensorimotor polyneuropathy. Direct muscle stimulation aids in differentiating CIP and CIM and in identifying mixed disorders along with other electrodiagnostic and histopathologic studies. Identifying evolving reductions in fibular CMAP amplitudes in intensive care unit (ICU) patients predicts development of neuromuscular weakness. Conclusions: Knowledge of the various neuromuscular disorders in critically ill patients, their risk factors, and associated electrodiagnostic findings can lead to development of a rational approach to diagnosis of the cause of neuromuscular weakness in ICU patients. Muscle Nerve 47: 452–463, 2013</div>
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