Acute quadriplegic myopathy: a complication of treatment with steroids, nondepolarizing blocking agents, or both.
We studied two patients who were given high-dose intravenous steroid therapy and were intubated for status asthmaticus. Both became quadriplegic and wasted within 2 weeks. EMG had myopathic abnormalities. Muscle biopsy revealed severe atrophy of most muscle fibers, with disorganization of myofibrils and selective loss of thick (myosin) filaments. Immunohistologic stains for myosin isoforms confirmed the decrease or absence of this protein. Both patients clinically improved over several months.
Hirano
M
M
New York Neurological Institute, Columbia-Presbyterian Medical Center, New York, NY 10032-3784.
Ott
B R
BR
Raps
E C
EC
Minetti
C
C
Lennihan
L
L
Libbey
N P
NP
Bonilla
E
E
Hays
A P
AP
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D011782:Quadriplegia / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology
D000305:Adrenal Cortex Hormones; D003473:Neuromuscular Nondepolarizing Agents