Acute quadriplegic myopathy unrelated to steroids or paralyzing agents: quantitative EMG studies.
BACKGROUND
Quadriplegic myopathy (QM) and its variants generally are described in critically ill patients who are exposed to steroids and nondepolarizing muscle blocking agents (NDMBAs).


METHODS
A patient with sepsis who was not exposed to steroids or an NDMBA infusion developed QM and was studied using serial quantitative electromyography.


RESULTS
Clinical and electrophysiological studies identified evidence of a severe myopathy and muscle biopsy showed necrosis, calcifications and selective loss of myosin filaments in non-necrotic fibers. Her clinical recovery paralleled rises in motor unit action potential (MUAP) amplitudes studied by serial automatic decomposition electromyography (ADEMG).


CONCLUSIONS
QM can develop with sepsis and without significant exposure to steroids and NDMBAs. ADEMG can be a useful tool in electrophysiological evaluation of critically ill patients with weakness.
Höke
A
A
Department of Clinical Neurosciences, University of Calgary, Canada.
Rewcastle
N B
NB
Zochodne
D W
DW
D000208:Acute Disease; D001706:Biopsy; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009431:Neural Conduction; D009466:Neuromuscular Blocking Agents; D011782:Quadriplegia / Q000209:etiology* / Q000473:pathology*; D013256:Steroids
D009466:Neuromuscular Blocking Agents; D013256:Steroids