The clinical spectrum of critical illness polyneuropathy.
OBJECTIVE
To describe the entity of critical illness polyneuropathy and review our experience with six cases.


METHODS
We present case reports of six patients with polyneuropathy associated with critical illness, who received medical care at the Mayo Clinic between 1992 and 1994, and discuss similar cases from the literature.


RESULTS
Critical illness may damage peripheral nerves. In previous studies, sepsis and multiorgan failure have been found to trigger a peripheral neuropathy. Of our six patients with critical illness polyneuropathy, all had a preceding severe bacterial infection or septic shock. In one patient who had long-term administration of vecuronium bromide and had received massive intravenous doses of corticosteroids, sural nerve and quadriceps muscle biopsy specimens were available; they revealed axonal neuropathy and notable myopathic changes, respectively. The outcome was good in patients who survived the critical illness.


CONCLUSIONS
Polyneuropathy in critically ill patients may be a cause of severe generalized limb weakness and occurs in the setting of a sepsis syndrome. The long-term outcome is good in patients who recover from the underlying critical illness. Compression neuropathies may be a cause of permanent sequelae.
Wijdicks
E F
EF
Department of Neurology, Mayo Clinic Rochester, MN 55905.
Litchy
W J
WJ
Harrison
B A
BA
Gracey
D R
DR
D000208:Acute Disease; D000368:Aged; D001424:Bacterial Infections / Q000150:complications*; D016638:Critical Illness; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications*; D009431:Neural Conduction; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D010195:Pancreatitis / Q000150:complications; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D012131:Respiratory Insufficiency / Q000150:complications; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications*; D012772:Shock, Septic / Q000150:complications; D013530:Surgical Wound Infection / Q000150:complications
D009466:Neuromuscular Blocking Agents