Neuromuscular disorders in severe acute respiratory syndrome.
OBJECTIVE
To delineate and clarify neuromuscular disorders in patients with probable severe acute respiratory syndrome (SARS).


METHODS
Case series with follow-up ranging from 3 weeks to 2 months.


METHODS
National Taiwan University Hospital, Taipei.


METHODS
We investigated 4 patients with SARS who had concomitant neuromuscular problems. A diagnosis of SARS was based on the demonstration of serum coronavirus antibodies. Clinical presentations, laboratory results, electrophysiologic findings, and follow-up conditions were determined.


RESULTS
Patients developed neuromuscular problems approximately 3 weeks after the onset of SARS. Two women experienced motor-predominant peripheral nerve disorders. A man developed myopathy and a third woman experienced neuropathy and myopathy. Cerebrospinal fluid obtained from 2 patients with neuropathy disclosed normal protein content and the absence of pleocytosis and SARS coronavirus antibodies. Both patients with myopathy had elevated serum creatine kinase levels. A rapid clinical and electrophysiologic improvement was evident during follow-up examinations, with a good prognosis.


CONCLUSIONS
The neuromuscular problems in patients with SARS are considered to be critical-illness polyneuropathy or myopathy, possibly coexistent. Further pathological and microbiological studies are necessary to determine the relationship between SARS coronavirus and neuromuscular problems.
Tsai
Li-Kai
LK
Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.
Hsieh
Sung-Tsang
ST
Chao
Chi-Chao
CC
Chen
Yee-Chun
YC
Lin
Yea-Huey
YH
Chang
Shan-Chwen
SC
Chang
Yang-Chyuan
YC
D000328:Adult; D002555:Cerebrospinal Fluid / Q000737:chemistry; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000209:etiology* / Q000473:pathology*; D045169:Severe Acute Respiratory Syndrome / Q000150:complications*