Neuromuscular complications associated with liver transplantation.
We studied neuromuscular complications in a cohort of 520 patients with liver transplantation. Perioperative mononeuropathy developed in 9 patients. The peroneal nerve, radial nerve, and cutaneous branch of the femoral nerve were affected in 2 patients each. Two patients had herpes zoster-associated radiculopathy, and 1 patient had Horner's syndrome. Recovery was good in most patients. In 7 patients, severe quadriplegia complicated the perioperative course. In 5 patients, electrophysiologic studies suggested acute necrotic myopathy, and muscle biopsy specimens showed evidence of rhabdomyolysis in 1 patient. Outcome in survivors was good, all recovering completely. We conclude that neuromuscular complications in liver transplantation are uncommon (less than 1%) and do not significantly contribute to morbidity. Mononeuropathies may have iatrogenic perioperative causes, and rhabdomyolysis may be an important cause of generalized muscle weakness after liver transplantation.
Wijdicks
E F
EF
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Litchy
W J
WJ
Wiesner
R H
RH
Krom
R A
RA
D000328:Adult; D015331:Cohort Studies; D004594:Electrophysiology; D005260:Female; D005267:Femoral Nerve; D006562:Herpes Zoster / Q000150:complications; D006732:Horner Syndrome / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D016031:Liver Transplantation; D008160:Lumbosacral Plexus / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009336:Necrosis; D009468:Neuromuscular Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D010543:Peroneal Nerve; D011183:Postoperative Complications / Q000503:physiopathology*; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology; D011826:Radial Nerve; D011843:Radiculopathy / Q000209:etiology; D012189:Retrospective Studies