[Neurological manifestations in critically ill patients].
OBJECTIVE
To describe the pathophysiology, diagnosis and clinical manifestations of the neurological complications that critically ill patients often develop in intensive care units, and to discuss their treatment and prognosis, in the light of the most significant contemporary literature.


METHODS
The most frequent complication suffered by critically ill patients is sepsis, with encephalopathy as the main manifestation, and this has a direct effect on their prognosis. Polyneuropathy of the critically ill patient is linked to sepsis, as the main precipitating factor, as well as to the presence of high levels of glucose, which plays an important role in deciding whether mechanical ventilation can be withdrawn or not. Myopathy of the critically ill patient is related to the use of fluorinated steroids and neuromuscular blockers, which are frequently administered to these patients. All these entities represent a significant diagnostic challenge for the physician and are accompanied by important sequelae that continue after the patient's discharge from hospital, as well as myopathies and neuropathies associated to the use of drugs that are commonly administered to critically ill patients. It is therefore necessary to be familiar with the pathophysiology of the damage and with the associated factors, if a suitable diagnostic approach is to be employed.


CONCLUSIONS
The incidence of these pathologies and their complications makes them important conditions that require a swift, accurate diagnosis so that treatment can be established early on and a prognosis can also be determined.
López-Rodríguez
L
L
Servicio de Medicina Interna, Hospital Regional Lic. Adolfo López Mateos, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado, México DF, Mexico.
Hidalgo-Alquicira
F G
FG
Mimenza-Alvarado
A J
AJ
D018674:Adrenergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000617:Aminoglycosides / Q000009:adverse effects / Q000627:therapeutic use; D000638:Amiodarone / Q000009:adverse effects / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D016638:Critical Illness; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007362:Intensive Care Units; D007741:Labetalol / Q000009:adverse effects / Q000627:therapeutic use; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use; D009468:Neuromuscular Diseases / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D011115:Polyneuropathies / Q000209:etiology / Q000378:metabolism; D011379:Prognosis; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use; D018805:Sepsis / Q000150:complications / Q000378:metabolism; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use
D018674:Adrenergic Antagonists; D000617:Aminoglycosides; D018686:Anesthetics, Intravenous; D000889:Anti-Arrhythmia Agents; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D000927:Anticonvulsants; D007166:Immunosuppressive Agents; D008795:Metronidazole; D010672:Phenytoin; D016572:Cyclosporine; D009853:Omeprazole; D000638:Amiodarone; D007741:Labetalol; D016559:Tacrolimus; D015742:Propofol